Provider Demographics
NPI:1366137440
Name:SURGERY CENTER OF GEORGETOWN, LLC
Entity type:Organization
Organization Name:SURGERY CENTER OF GEORGETOWN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:REHM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-665-2324
Mailing Address - Street 1:1101 WOLF LAKE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-3778
Mailing Address - Country:US
Mailing Address - Phone:737-340-4100
Mailing Address - Fax:737-340-4101
Practice Address - Street 1:1101 WOLF LAKE DR STE 150
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3778
Practice Address - Country:US
Practice Address - Phone:377-340-4100
Practice Address - Fax:737-340-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical