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NPI Code Detail

MEDICARE: SURGERY CENTER OF DUNCANVILLE, LP

MEDICARE: SURGERY CENTER OF DUNCANVILLE, LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center007245TX

General Provider Information

NPI Number : 1194727289
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGERY CENTER OF DUNCANVILLE, LP
Provider Business Mailing Address
First Line : 1018 E WHEATLAND RD
Second Line :
City : DUNCANVILLE
State : TX
Zip : 75116-4914
Country : US
Telephone Number : 972-296-6912
Fax Number : 972-296-1387
Provider Business Practice Location Address
First Line : 1018 E WHEATLAND RD
Second Line :
City : DUNCANVILLE
State : TX
Zip : 75116-4914
Country : US
Telephone Number : 972-296-6912
Fax Number : 972-296-1387
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. DAVID P GROSS
Credential :
Telephone Number : 972-775-8589
Provider Enumeration Date : 06/02/2005
Last Update Date : 08/22/2020

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Directions to “SURGERY CENTER OF DUNCANVILLE, LP ” Practice Location

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