Provider Demographics
NPI:1437325347
Name:TOMBALL AMBULATORY SURGERY CENTER LP
Entity type:Organization
Organization Name:TOMBALL AMBULATORY SURGERY CENTER LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:H
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:281-351-7483
Mailing Address - Street 1:13500 MEDICAL COMPLEX DR
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6545
Mailing Address - Country:US
Mailing Address - Phone:281-290-8282
Mailing Address - Fax:832-559-5049
Practice Address - Street 1:13500 MEDICAL COMPLEX DRIVE
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-401-7638
Practice Address - Fax:281-357-2273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC403OtherASC403
TXASC403OtherASC403