Provider Demographics
NPI:1124894423
Name:KS SC LLC
Entity type:Organization
Organization Name:KS SC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR, REVENUE CYCLE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:BURCH
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-442-5027
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:CENTRAL BUSINESS OFFICE (ASC)
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-5669
Mailing Address - Fax:713-442-2760
Practice Address - Street 1:22407 HOLZWARTH ROAD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-1917
Practice Address - Country:US
Practice Address - Phone:346-674-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KELSEY-SEYBOLD MEDICAL GROUP, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-28
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical