MEDICARE: SURGERY MONITORING ASSOCIATES PA

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

General Provider Information

NPI Number	:	1922302264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGERY MONITORING ASSOCIATES PA

Provider Business Mailing Address
First Line	:	13161 MISTY WILLOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5635
Country	:	US
Telephone Number	:	281-970-5900
Fax Number	:	281-970-5913

Provider Business Practice Location Address
First Line	:	13161 MISTY WILLOW DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-5635
Country	:	US
Telephone Number	:	281-970-5900
Fax Number	:	281-970-5913

Authorized Official
Title or Position	:	DIRECTOR OF BILLING
Name	:	MISS DEBI GLICK
Credential	:
Telephone Number	:	972-792-5700

Provider Enumeration Date	:	12/30/2010
Last Update Date	:	12/30/2010

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