Provider Demographics
NPI:1841454071
Name:NASSAU AMBULATORY CENTER LLC
Entity type:Organization
Organization Name:NASSAU AMBULATORY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN. ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-554-7500
Mailing Address - Street 1:3750 MEDICAL PARK DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3750 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539
Practice Address - Country:US
Practice Address - Phone:173-554-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008379261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical