Provider Demographics
NPI:1124492541
Name:MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC
Entity type:Organization
Organization Name:MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAFTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-729-4009
Mailing Address - Street 1:9305 PINECROFT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3482
Mailing Address - Country:US
Mailing Address - Phone:713-343-0844
Mailing Address - Fax:972-559-1987
Practice Address - Street 1:9305 PINECROFT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3482
Practice Address - Country:US
Practice Address - Phone:832-823-5156
Practice Address - Fax:972-559-1987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-23
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical