Provider Demographics
NPI:1306846464
Name:TSA-TEXAS SURGICAL ASSOCIATES LLP
Entity type:Organization
Organization Name:TSA-TEXAS SURGICAL ASSOCIATES LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-709-1418
Mailing Address - Street 1:PO BOX 3567
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3567
Mailing Address - Country:US
Mailing Address - Phone:713-776-0655
Mailing Address - Fax:713-776-1069
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-776-0655
Practice Address - Fax:713-776-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0003BDOtherBCBS
TX095036202Medicaid
TX095036202Medicaid