Organization
PREMIER SURGEONS MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MENEFEE METTAUER M.D. (PRESIDENT/OWNER)
(713) 471-5450
Entity
Organization
Contact information
Practice address
17450 ST LUKES WAY STE 290, THE WOODLANDS, TX 77384-8045
(936) 283-0264
(936) 828-2498
Mailing address
PO BOX 4248 DEPT #315, HOUSTON, TX 77210-4248
(936) 283-0264
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
K6486
TX
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
K6486
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1560930-03
—
TX
Enumeration date
12/15/2015
Last updated
09/25/2019
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