Humble Vascular Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HUMBLE VASCULAR SURGICAL CENTER LLC

Practice address

8411 FM 1960 Bypass Rd W Ste a
Humble, TX 77338-4013

Phone

(346) 214-1743

Fax

(281) 570-2579

NPI assigned

Oct 13, 2017

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospital certification: CCN 670140

Legal name

HUMBLE VASCULAR SURGICAL CENTER

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

Apr 7, 2020

Last certification

Apr 7, 2020

Beds

1

Ownership / control type

Private (not for profit)

Facility address

8411 FM 1960 Bypass Rd W, Suite a
Humble, TX 77338

Listed as

Humble Vascular Surgical CenterCCN 45C0001673

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1699286922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8411 FM 1960 BYPASS RD W STE A",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384013",
            "telephone_number": "346-214-1743",
            "fax_number": "281-570-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8411 FM 1960 BYPASS RD W STE A",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773384013",
            "telephone_number": "346-214-1743",
            "fax_number": "281-570-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBLE VASCULAR SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-13",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EMR",
            "affiliation": "N",
            "address_1": "8411 Fm 1960 Bypass Rd W Ste A",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773384013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Humble Spine Surgery, PLLC
• Humble Sports Orthopaedics, PLLC
• Humble Surgical Hospital, LLC
• Humble Treatment Services PLLC
• Humble Twelve Diagnostics PLLC
• Humbok Neurosurgery, PLLC
• Erin Elizabeth Hunnicutt, PHARM. D.
• Clare Hunt, PT, DPT
• Madeline Anderson Hunt, MD
• Charmayne Hunter, MA, LCDC

• 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 Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.