Renaissance Surgical Center-Northeast, L.L.P

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

261QA1903X Issued in TX

Legal business name

RENAISSANCE SURGICAL CENTER-NORTHEAST, L.L.P

Practice address

18929 Highway 59 N
Humble, TX 77338-4270

Phone

(713) 532-7311

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Mustapha Kibirige, M.D.

Title

President

Phone

(713) 532-7311

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1275600751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773470669",
            "telephone_number": "713-532-7311",
            "fax_number": "713-532-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18929 HIGHWAY 59 N",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384270",
            "telephone_number": "713-532-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE SURGICAL CENTER-NORTHEAST, L.L.P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "KIBIRIGE",
        "authorized_official_first_name": "MUSTAPHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-532-7311",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "261QA1903X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP #",
            "identifier": "HH1370",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1586968-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Reliable Universal Operations, PLLC
• Relief Pain and Wellness
• Shundra Reliford
• Renaissance North East Surgery Center
• Renaissance Northeast Surgery Center
• Aaron Reneau, O.D.
• Jared N Reneau, PTA
• Renew Surgical Center, PA
• Renewed Hope Counseling Center
• Jesus Arnulfo Renteria, LPC

• Ambulatory Surgical Clinic/Center in Humble, TX
• Providers in Humble, 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 Jun 21, 2018; 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.