| |
3375 Westpark Dr, Unit 442, Houston, TX 77005-4262 | |
(832) 523-3066 | |
(832) 602-2638 |
Full Name | |
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Type | Facility |
Speciality | Physician Assistant - Surgical |
Location | 3375 Westpark Dr, Houston, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912353905 | NPI | - | NPPES |
00P07U | Other | TX | BCBS - OLTON SURGICAL SERVICES, LLC |
SA00606 | Other | TX | SURGICAL ASSISTANT'S LICENSE |
Mailing Address | Practice Location Address |
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Po Box 541602, Houston, TX 77254-1602 Ph: (832) 523-3066 | 3375 Westpark Dr, Unit 442, Houston, TX 77005-4262 Ph: (832) 523-3066 |