Shoreline Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SHORELINE SURGERY CENTER, LLC

Practice address

6701 Lake Woodlands Dr Ste 180
The Woodlands, TX 77382-2565

Phone

(281) 825-4627

Fax

(800) 878-0301

NPI assigned

Feb 21, 2023

Organization subpart

No

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

Authorized official

Name

Vim X Head

Title

Ceo

Phone

(281) 825-4627

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1396443115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 LAKE WOODLANDS DR STE 180",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822565",
            "telephone_number": "281-825-4627",
            "fax_number": "800-878-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 LAKE WOODLANDS DR STE 180",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773822565",
            "telephone_number": "281-825-4627",
            "fax_number": "800-878-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "HEAD",
        "authorized_official_first_name": "VIM",
        "authorized_official_middle_name": "X",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-825-4627"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nevaeh Shields
• Mona A Shihadeh-Smith, MD
• Julie Shilling
• Sarah Shirley
• Samir Pradeep Shirodkar, MD
• Christine Short, DPT
• Elizabeth Michelle Baxter Shosa, OD
• SHR Counseling Services, LLC
• Jessica Shrieve, LPC
• Kelly Shum, MD

• Ambulatory Surgical Clinic/Center in The Woodlands, TX
• Providers in The Woodlands, 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 Feb 21, 2023; 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.