MEDICARE: HOUSTON METRO ORTHO AND SPINE SURGERY CENTER,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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1952697682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON METRO ORTHO AND SPINE SURGERY CENTER,LLC

Provider Business Mailing Address
First Line	:	2100 WEST LOOP S STE 1200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-3599
Country	:	US
Telephone Number	:	713-877-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4219 RICHMOND AVE STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-6838
Country	:	US
Telephone Number	:	713-877-0600
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LORI RAMIREZ
Credential	:
Telephone Number	:	713-877-0600

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	06/21/2011

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