Organization
PREMIER GENERAL AND COLORECTAL SURGERY, PA
Active
Other names
premier general and colorectal surgery PA
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY KIM (OFFICE MANAGER)
(832) 303-2922
Entity
Organization
Contact information
Practice address
129 VISION PARK BLVD STE 212, SHENANDOAH, TX 77384-3024
(832) 303-2922
(866) 923-1223
Mailing address
129 VISION PARK BLVD STE 212, SHENANDOAH, TX 77384-3024
(832) 303-2922
(866) 923-1223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
N3791
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K0169364
DPS
—
01
—
N3791
LICENSE
—
Enumeration date
08/02/2012
Last updated
03/07/2023
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