# LAREDO SURGICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710595996
- **Authorized official:** DON VICKERS M.ED. (CEO)
- **Authorized official phone:** (281) 777-0878

## Contact information

- **Practice address:** 10410 MEDICAL LOOP BLDG 4A, LAREDO, TX 78045-6672
- **Practice address phone:** (281) 777-0878
- **Mailing address:** 4606 PAYTON CHASE LN, KATY, TX 77494-3080
- **Mailing address phone:** (281) 777-0878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 07/14/2020
- **Last updated:** 04/28/2022