MEDICARE: SURGICAL ASSOCIATES

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	174400000X	Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00DG36	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912002023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	6560 FANNIN ST
Second Line	:	SUITE 1654
City	:	HOUSTON
State	:	TX
Zip	:	77030-2734
Country	:	US
Telephone Number	:	713-797-1211
Fax Number	:	713-795-9805

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST
Second Line	:	SUITE 1654
City	:	HOUSTON
State	:	TX
Zip	:	77030-2734
Country	:	US
Telephone Number	:	713-797-1211
Fax Number	:	713-795-9805

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	RICHARD CLARENCE GEIS
Credential	:	M.D.
Telephone Number	:	713-797-1211

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/22/2010

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Directions to “SURGICAL ASSOCIATES ” Practice Location

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