Organization
SOUTHWEST SURGICAL ASSOCIATES LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOYCE CARPENTER (ADMINISTRATOR)
(713) 255-6355
Entity
Organization
Contact information
Practice address
7777 SOUTHWEST FWY STE 810, HOUSTON, TX 77074-1811
(713) 772-1200
(713) 772-0258
Mailing address
13811 MURPHY RD, STAFFORD, TX 77477-4903
(713) 255-6310
(713) 255-6315
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083465701
—
TX
01
—
77074A001
GROUP TRICARE ID#
TX
01
—
CS7997
RR MEDICARE PIN
TX
Enumeration date
11/10/2006
Last updated
01/18/2024
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