Healthcare Provider Details

I. General information

NPI: 1609893379
Provider Name (Legal Business Name): SUMMIT SURGERY CENTER LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 W 15TH ST SUITE 150
PLANO TX
75075-4737
US

IV. Provider business mailing address

PO BOX 678692
DALLAS TX
75267-8692
US

V. Phone/Fax

Practice location:
  • Phone: 972-543-2468
  • Fax: 972-543-2465
Mailing address:
  • Phone: 972-758-3595
  • Fax: 972-599-9604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number007810
License Number StateTX

VIII. Authorized Official

Name: DR. SCOTT HARRIS
Title or Position: PARTNER
Credential: MD
Phone: 972-543-2468