Provider Demographics
NPI:1891861225
Name:ELEGANT SURGERY, P.A.
Entity type:Organization
Organization Name:ELEGANT SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIKOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-465-0696
Mailing Address - Street 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 353
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-465-0696
Mailing Address - Fax:713-465-7334
Practice Address - Street 1:9180 OLD KATY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7454
Practice Address - Country:US
Practice Address - Phone:713-647-7700
Practice Address - Fax:713-647-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4483261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical