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Organization

BAYSHORE SURGERY CENTER, LTD

Active
Other names
Bayshore Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
DON LIEDTKE (VICE PRESIDENT)
(615) 344-5507
Entity
Organization

Contact information

Practice address
3333 BAYSHORE BLVD, PASADENA, TX 77504-1952
(832) 386-0320
(832) 386-0240
Mailing address
3333 BAYSHORE BLVD, PASADENA, TX 77504-1952
(832) 386-0320
(832) 386-0240

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
007306
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144393901
TX
Enumeration date
04/07/2006
Last updated
10/22/2007
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