Organization
MAGNA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIPTI BAVISHI M.D. (MEDICAL DIRECTOR)
(713) 686-2462
Entity
Organization
Contact information
Practice address
3726 DACOMA ST, SUITE 100, HOUSTON, TX 77092-8906
(713) 686-2462
Mailing address
3726 DACOMA ST, SUITE 100, HOUSTON, TX 77092-8906
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/05/2014
Last updated
07/23/2015
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