1073837290 NPI number — ASP WORTHAM SURGERY CENTER, LLC

Table of content: MISS SUSANNA JENNIFER STEGGLES MSW (NPI 1861597601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073837290 NPI number — ASP WORTHAM SURGERY CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASP WORTHAM SURGERY CENTER, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073837290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13114 FM 1960 RD W
Provider Second Line Business Mailing Address:
SUITE 118
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77065-4290
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-559-9100
Provider Business Mailing Address Fax Number:
713-559-9109

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13114 FM 1960 RD W
Provider Second Line Business Practice Location Address:
SUITE 118
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065-4290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-559-9100
Provider Business Practice Location Address Fax Number:
713-559-9109
Provider Enumeration Date:
03/17/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BRUCE
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING PARTNER/CFO
Authorized Official Telephone Number:
713-554-7500

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  130052 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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