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Organization
MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD.
Active
Organization
MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD.
Active
Other names
Doctors Outpatient Surgicenter
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
3534 VISTA RD, PASADENA, TX 77504-1728
(713) 947-0330
(713) 947-6562
Mailing address
3534 VISTA RD, PASADENA, TX 77504-1728
(713) 947-0330
(713) 947-6562
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
007116
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10021532
—
TX
01
—
490004677
RAILROAD MEDICARE
TX
Enumeration date
06/08/2005
Last updated
07/24/2019
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