Organization
EXECUTIVE SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED TAREK AL-FAHL MD (OWNER/PHYSICIAN)
(832) 698-3720
Entity
Organization
Contact information
Practice address
13603 MICHEL RD, TOMBALL, TX 77375-6410
(832) 698-3720
(832) 698-3721
Mailing address
13603 MICHEL RD SUITE 100, TOMBALL, TX 77375
(832) 698-3720
(832) 698-3721
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/07/2013
Last updated
11/04/2016
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