NPI | 1841409281 |
---|---|
Former Legal Business Name | S.T.A.E.C. |
Entity Type | Organization |
Authorized Contact | CHARLES GEORGE POLSEN Doctor 281-538-6600 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: TX 2974) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2020-08-22 |