MEDICARE: MESQUITE TX ENDOSCOPY ASC LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528253523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MESQUITE TX ENDOSCOPY ASC LLC

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-6153
Country	:	US
Telephone Number	:	615-240-3741
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	2704 N GALLOWAY AVE
Second Line	:	SUITE 102
City	:	MESQUITE
State	:	TX
Zip	:	75150-6378
Country	:	US
Telephone Number	:	972-270-3590
Fax Number	:	972-270-3572

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY E SNODGRASS
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	09/12/2007
Last Update Date	:	08/27/2025

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Directions to “MESQUITE TX ENDOSCOPY ASC LLC ” Practice Location

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