CRYSTAL OUTPATIENT SURGERY CENTER LAKE JACKSON NPI 1417172891

NPI Information

NPI: 1417172891
Provider Name: CRYSTAL OUTPATIENT SURGERY CENTER LAKE JACKSON
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
215 OAK DRIVE SOUTH
SUITE J
HOUSTON, TX
ZIP 77024
Phone: (713) 467-9413
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CRYSTAL OUTPATIENT SURGERY CENTER LAKE JACKSON is an ambulatory surgical clinic center in Houston, TX. CRYSTAL OUTPATIENT SURGERY CENTER LAKE JACKSON NPI is 1417172891. The provider is registered as an organization entity type.

The provider's business location address is:

215 OAK DRIVE SOUTH
SUITE J
HOUSTON, TX
ZIP 77024
Phone: (713) 467-9413

The provider's authorized official is Robert Scott Yarish .
The authorized official title is President and has the following contact phone number (713) 467-0146.

The enumeration date for this NPI number is 4/13/2007 and was last updated on 10/5/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	000269	TEXAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	451156	MEDICARE ID-TYPE UNSPECIFIED	TEXAS

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: 5/5/2024

NPI Synchronization or Removal

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