Provider Demographics
NPI:1699311936
Name:GRAND PARKWAY SURGICAL INSTITUTE LLC
Entity type:Organization
Organization Name:GRAND PARKWAY SURGICAL INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DAYNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:713-877-0600
Mailing Address - Street 1:7830 W GRAND PKWY S STE 150
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-5819
Mailing Address - Country:US
Mailing Address - Phone:281-456-4188
Mailing Address - Fax:833-692-0041
Practice Address - Street 1:7830 W GRAND PKWY S STE 150
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5819
Practice Address - Country:US
Practice Address - Phone:281-456-4188
Practice Address - Fax:833-692-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty