East Shore Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EAST SHORE SURGERY CENTER LLC

Practice address

1006 Windsor Lakes Blvd Ste 100
The Woodlands, TX 77384-4974

Phone

(346) 237-5899

Fax

(888) 391-9429

NPI assigned

Nov 25, 2024

Last updated

Nov 25, 2024By 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

Serge Awasum, MD

Title

Sole Owner

Phone

(832) 576-8418

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1700602612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 WINDSOR LAKES BLVD STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 WINDSOR LAKES BLVD STE 100",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844974",
            "telephone_number": "346-237-5899",
            "fax_number": "888-391-9429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SHORE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "AWASUM",
        "authorized_official_first_name": "SERGE",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "832-576-8418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Dyer, APRN
• Drew Aric Dylewski, M.D.
• E Plus Pet Imaging VIII LP (PET Imaging of The Woodlands)
• Gregory Lee Eads, MD
• Kenna Earles, MA, LPC-A, CTP
• East Texas Clinical Services, Inc (CHI St. Luke's Health Neighborhood Pharmacy #3)
• Terry Ann Eavenson, LMRT
• Ebf Eye Pro, LLC
• Deborah Jean Eckert, O.T.
• Mary Edgerly

• 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 Nov 25, 2024; 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.