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Organization

MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD.

Active
Other names
Doctors Outpatient Surgicenter
Organization subpart
No

Provider details

NPI number
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization

Contact information

Practice address
3534 VISTA RD, PASADENA, TX 77504-1728
(713) 947-0330
(713) 947-6562
Mailing address
3534 VISTA RD, PASADENA, TX 77504-1728
(713) 947-0330
(713) 947-6562

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
007116
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10021532
TX
01
490004677
RAILROAD MEDICARE
TX
Enumeration date
06/08/2005
Last updated
07/24/2019
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