Basic Information
| Provider Information | |||||||||
| NPI: | 1518171891 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | COLORECTAL SURGICAL ASSOCIATES, LTD, L.L.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7900 FANNIN ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770542934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137900600 | ||||||||
| FaxNumber: | 7137900616 | ||||||||
| Practice Location | |||||||||
| Address1: | 7900 FANNIN ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770542934 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137900600 | ||||||||
| FaxNumber: | 7137900616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PRITCHETT | ||||||||
| AuthorizedOfficialFirstName: | BECKEY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7137900600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | M4269 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.