MEDICARE: SURGICAL SERVICE FU LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1881228740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL SERVICE FU LLC

Provider Business Mailing Address
First Line	:	7919 GARLAND PATH BEND LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2757
Country	:	US
Telephone Number	:	832-748-1762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 BINZ ST STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6944
Country	:	US
Telephone Number	:	713-520-1210
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HONGWEI FU
Credential	:
Telephone Number	:	832-748-1762

Provider Enumeration Date	:	02/28/2020
Last Update Date	:	02/28/2020

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Directions to “SURGICAL SERVICE FU LLC ” Practice Location

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