Healthcare Provider Details

I. General information

NPI: 1497724942
Provider Name (Legal Business Name): PARK VENTURA ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 PRESTON RD STE 200
PLANO TX
75093-8644
US

IV. Provider business mailing address

1A BURTON HILLS BLVD STE 300
NASHVILLE TN
37215-6153
US

V. Phone/Fax

Practice location:
  • Phone: 972-985-2300
  • Fax: 972-985-2320
Mailing address:
  • Phone: 615-240-3741
  • Fax: 615-234-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number007950
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY E. SNODGRASS
Title or Position: PRESIDENT
Credential:
Phone: 615-665-1283