Provider Demographics
NPI:1124319868
Name:WEST COAST SURGICAL, LTD
Entity type:Organization
Organization Name:WEST COAST SURGICAL, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THEDA
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:LABOME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-969-8738
Mailing Address - Street 1:PO BOX 18557
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-8557
Mailing Address - Country:US
Mailing Address - Phone:281-969-8738
Mailing Address - Fax:281-969-8882
Practice Address - Street 1:4501 CARTWRIGHT RD
Practice Address - Street 2:SUITE 606
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3534
Practice Address - Country:US
Practice Address - Phone:281-969-8738
Practice Address - Fax:281-969-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty