Provider Demographics
NPI:1730564410
Name:HUMBLE SURGICAL HOSPITAL, LLC
Entity type:Organization
Organization Name:HUMBLE SURGICAL HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KIGGUNDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-532-7311
Mailing Address - Street 1:5120 WOODWAY DR
Mailing Address - Street 2:SUITE 7012
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1723
Mailing Address - Country:US
Mailing Address - Phone:281-359-3223
Mailing Address - Fax:
Practice Address - Street 1:22751 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6021
Practice Address - Country:US
Practice Address - Phone:281-359-3223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital