Organization
ST MICHAELS CENTER FOR SPECIAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDOLPH ALPHONSE LOPEZ M.D., (MEDICAL DIRECTOR)
(713) 812-1612
Entity
Organization
Contact information
Practice address
3726 DACOMA ST, HOUSTON, TX 77092-8906
(713) 812-1612
Mailing address
PO BOX 924369, HOUSTON, TX 77292-4369
(713) 812-1612
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008261
TX
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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