Provider Demographics
NPI:1215140140
Name:BAY AREA SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:BAY AREA SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-332-4596
Mailing Address - Street 1:200 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4226
Mailing Address - Country:US
Mailing Address - Phone:281-332-4596
Mailing Address - Fax:281-332-9610
Practice Address - Street 1:200 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE #101
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4226
Practice Address - Country:US
Practice Address - Phone:281-332-4596
Practice Address - Fax:281-332-9610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9815208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H0893OtherBCBS
TXB23377Medicare UPIN
TXHE000M972Medicare ID - Type Unspecified