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PREMIER SURGEONS MANAGEMENT LLC NPI 1376908590


NPI Information

NPI: 1376908590
Provider Name: PREMIER SURGEONS MANAGEMENT, LLC
Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
Entity Type: Organization
Address:
17450 ST LUKES WAY STE 290
THE WOODLANDS, TX
ZIP 77384
Phone: (936) 283-0264
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PREMIER SURGEONS MANAGEMENT, LLC is a thoracic surgery cardiothoracic vascular surgery in The Woodlands, TX. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. PREMIER SURGEONS MANAGEMENT, LLC NPI is 1376908590. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17450 ST LUKES WAY STE 290
THE WOODLANDS, TX
ZIP 77384-045
Phone: (936) 283-0264
Fax: (936) 828-2498

The provider's authorized official is Mark Menefee Mettauer .
The authorized official title is President/owner and has the following contact phone number (713) 471-5450.

The enumeration date for this NPI number is 12/15/2015 and was last updated on 9/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryK6486TEXASNo
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)K6486TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11560930-03MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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