Provider Demographics
NPI:1063870012
Name:AIP PROCEDURE SUITE, LLC
Entity type:Organization
Organization Name:AIP PROCEDURE SUITE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-292-7411
Mailing Address - Street 1:1544 SAWDUST RD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2929
Mailing Address - Country:US
Mailing Address - Phone:281-292-7411
Mailing Address - Fax:281-292-7481
Practice Address - Street 1:21830 KINGSLAND BLVD STE 102
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2500
Practice Address - Country:US
Practice Address - Phone:281-292-7411
Practice Address - Fax:281-292-7481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty