Premier Surgeons Management, LLC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

K6486 Issued in TX

Legal business name

PREMIER SURGEONS MANAGEMENT, LLC

Practice address

17450 St Lukes Way Ste 290
The Woodlands, TX 77384-8045

Phone

(936) 283-0264

Fax

(936) 828-2498

NPI assigned

Dec 15, 2015

Last updated

Sep 25, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark Menefee Mettauer, M.D.NPI 1427043967

Title

President/Owner

Phone

(713) 471-5450

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Menefee Mettauer, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • The Woodlands, TX
  • NPI 1427043967
  Authorized official Same address or phone

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1376908590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4248 DEPT #315",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104248",
            "telephone_number": "936-283-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17450 ST LUKES WAY STE 290",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848045",
            "telephone_number": "936-283-0264",
            "fax_number": "936-828-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGEONS MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "METTAUER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MENEFEE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "713-471-5450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "K6486",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "K6486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1560930-03",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; 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.