Provider Demographics
NPI:1285699835
Name:WEBSTER SURGICAL SPECIALTY HOSPITAL, LLC
Entity type:Organization
Organization Name:WEBSTER SURGICAL SPECIALTY HOSPITAL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:CRAFTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-557-5621
Mailing Address - Street 1:PO BOX 4396
Mailing Address - Street 2:DEPT 496
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4396
Mailing Address - Country:US
Mailing Address - Phone:281-557-5620
Mailing Address - Fax:281-335-1708
Practice Address - Street 1:333 N TEXAS AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4962
Practice Address - Country:US
Practice Address - Phone:281-557-5620
Practice Address - Fax:281-335-1708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008220282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1082OtherBLUE CROSS BLUE SHIELD
TXHH1082OtherBLUE CROSS BLUE SHIELD