Provider Demographics
NPI:1871050864
Name:ALLIANCE ASC, LLC
Entity type:Organization
Organization Name:ALLIANCE ASC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:REGGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-277-5679
Mailing Address - Street 1:21155 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-7101
Mailing Address - Country:US
Mailing Address - Phone:713-277-5679
Mailing Address - Fax:281-810-1064
Practice Address - Street 1:21155 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-7101
Practice Address - Country:US
Practice Address - Phone:281-810-1060
Practice Address - Fax:281-810-1064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical