Organization
NASA SURGICAL SUITE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES DIETER (MANAGER)
(281) 404-3164
Entity
Organization
Contact information
Practice address
250 BLOSSOM ST, SUITE 120B, WEBSTER, TX 77598-4204
(281) 404-3164
Mailing address
250 BLOSSOM ST, SUITE 120B, WEBSTER, TX 77598-4204
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
09/18/2012
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