Healthcare Provider Details

I. General information

NPI: 1427089960
Provider Name (Legal Business Name): ARLINGTON SURGICAL ASSOCIATION PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N WALDROP DR STE. 802
ARLINGTON TX
76012-4705
US

IV. Provider business mailing address

1001 N WALDROP DR STE. 802
ARLINGTON TX
76012-4705
US

V. Phone/Fax

Practice location:
  • Phone: 817-275-3309
  • Fax: 817-265-0071
Mailing address:
  • Phone: 817-275-3309
  • Fax: 817-265-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number601580
License Number StateTX

VIII. Authorized Official

Name: MANDY VALDEZ
Title or Position: BILLING MANAGER
Credential:
Phone: 817-275-3309