Basic Information
| Provider Information | |||||||||
| NPI: | 1992129795 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GLS UAP SUGARLAND, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15305 DALLAS PKWY | ||||||||
| Address2: | SUITE 1600 | ||||||||
| City: | ADDISON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750014637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727133547 | ||||||||
| FaxNumber: | 9725341568 | ||||||||
| Practice Location | |||||||||
| Address1: | 17510 W GRAND PKWY S | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774792645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812381600 | ||||||||
| FaxNumber: | 2812381650 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| AuthorizedOfficialLastName: | HARPER | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OFFICER / AUTHORIZED OFFIICIAL | ||||||||
| AuthorizedOfficialTelephone: | 9727133547 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.