Jackson Street Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130278 Issued in TX

Legal business name

JACKSON STREET SURGICAL CENTER LLC

Doing business as

Mid-Town Surgical Center

Practice address

2015 Jackson Street
Houston, TX 77003

Phone

(281) 974-2300

NPI assigned

Feb 24, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adity Sharma, MD

Title

Owner

Phone

(732) 698-1000

Specialties & licenses 1

Addresses

Other names 1

• Mid-Town Surgical Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1245690916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 JACKSON STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77003",
            "telephone_number": "281-974-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 JACKSON STREET",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77003",
            "telephone_number": "281-974-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON STREET SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "ADITY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-698-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "130278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Town Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Alan Jack II, M.D.
• Keri Lynne Jackman, LCSW
• Jackson Home Healthcare Inc
• Benyta Gail Jackson Nunley, RN
• Jackson Oculofacial and Cosmetic Surgery PA
• Joanna Jackson-Arinze, MSA DEGREE
• Chanell Monique Jackson-Blanton, PTA
• Heather Jackson-Brown, LCSW
• Lashonda Michill Jackson-Dean, DM,MBA,LHRP,CPT,CIVT
• Miranda C Jackson-Green

• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.