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Organization
LAKE TRAVIS SURGICAL ASSOCIATES PA
Active
Organization
LAKE TRAVIS SURGICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODIE R ELLIS CPC-H (BUSINESS OFFICE MANAGER)
(832) 201-5157
Entity
Organization
Contact information
Practice address
9300 KIRBY DRIVE, SUITE 100, HOUSTON, TX 77054
(832) 201-5157
(832) 201-5167
Mailing address
PO BOX 1759, DEPT 765, HOUSTON, TX 77251-1759
(832) 201-5157
(832) 201-5167
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/11/2007
Last updated
12/23/2008
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