MEDICARE: TP SPECIALTY SURGERY CENTER 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
1	261QA1903X	Ambulatory Surgical Clinic/Center	008361	TX

General Provider Information

NPI Number	:	1245384981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TP SPECIALTY SURGERY CENTER LP

Provider Business Mailing Address
First Line	:	630 N COIT RD
Second Line	:	SUITE 2200
City	:	RICHARDSON
State	:	TX
Zip	:	75080-3700
Country	:	US
Telephone Number	:	214-389-7362
Fax Number	:	214-389-7350

Provider Business Practice Location Address
First Line	:	8122 DATAPOINT DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3272
Country	:	US
Telephone Number	:	210-293-6500
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JOHN TITUS
Credential	:
Telephone Number	:	214-389-7400

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	05/09/2013

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