Provider Demographics
NPI:1124131628
Name:EAST HOUSTON SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:EAST HOUSTON SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-455-5531
Mailing Address - Street 1:4140 SOUTHWEST FREEWAY #425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027
Mailing Address - Country:US
Mailing Address - Phone:713-455-5531
Mailing Address - Fax:713-455-4321
Practice Address - Street 1:4140 SOUTHWEST FREEWAY #425
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:713-455-5531
Practice Address - Fax:713-455-4321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG97042086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX084785701Medicaid
TX084785701Medicaid