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Organization
LAKE BREEZE SURGICAL AFFILIATES, PA
Active
Organization
LAKE BREEZE SURGICAL AFFILIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE R ELLIS (BUSINESS OFFICE COORDINATOR)
(713) 355-8600
Entity
Organization
Contact information
Practice address
4120 SOUTHWEST FWY, 200, HOUSTON, TX 77027-7339
(713) 355-8600
(713) 355-8069
Mailing address
PO BOX 1759, DEPT 721, HOUSTON, TX 77251-1759
(713) 355-8600
(713) 355-8069
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
08/22/2020
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