NPIMap

Organization Active NPI

Deerbrook ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Humble, TX
National Provider Identifier
1699246181
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
DEERBROOK ASC LLC
Practice address
18450 Hwy 59 Suite 101-B
Humble, TX 77338
Phone
(281) 446-6656
Fax
(281) 446-6657
NPI assigned
Dec 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
Ricky Ganim, MDNPI 1295843019
Title
Manager
Phone
(281) 446-6656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

18450 Hwy 59 Suite 101-B
Humble, TX 77338

Mailing address

18450 Hwy 59 Suite 101-B
Humble, TX 77338
Phone (281) 446-6656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190301000034 TX Part B Supplier - Ambulatory Surgical Center 1850630229 Practice locations: Humble, TX

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Vital Heart and Vein ASC Dba Deerbrook ASC LLCCCN 45C0001680
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2172112Deerbrook ASC, LLC18450 Hwy 59, Ste 101-B, Humble, TX 77338AccreditationJun 16, 2028

National Provider Directory

National Provider Directory

Locations

18450 Highway 59 N
#101
Humble, TX 77338

18450 Highway 59 N
Ste 101B
Humble, TX 77338
Phone (281) 572-0224

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1699246181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18450 HWY 59 SUITE 101-B",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77338",
            "telephone_number": "281-446-6656",
            "fax_number": "281-446-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18450 HWY 59 SUITE 101-B",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "77338",
            "telephone_number": "281-446-6656",
            "fax_number": "281-446-6657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEERBROOK ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "GANIM",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-446-6656",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.