Healthcare Provider Details

I. General information

NPI: 1174069355
Provider Name (Legal Business Name): PARKWAY SURGICENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 SPRING STUEBNER RD 100
SPRING TX
77389-5194
US

IV. Provider business mailing address

3301 SPRING STUEBNER RD 100
SPRING TX
77389-5194
US

V. Phone/Fax

Practice location:
  • Phone: 346-262-0300
  • Fax:
Mailing address:
  • Phone: 346-262-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KENNETH LE
Title or Position: PRESIDENT
Credential:
Phone: 346-262-0300