Organization
SUREGUARD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE BROCHSTEIN (EXECUTIVE DIRECTOR OF CORPORATE OPS)
(713) 703-8642
Entity
Organization
Contact information
Practice address
10007 KENNERLY RD STE B, SAINT LOUIS, MO 63128-2179
(866) 280-1543
Mailing address
5307 JASON ST, HOUSTON, TX 77096-1232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Enumeration date
05/09/2024
Last updated
12/23/2024
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