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General NPI Number Information
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NPI Number | 1023071560
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Entity Type | Organization
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Legal Business Name | MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES, L.P.
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Dates
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Enumeration Date | 04/07/2006
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 909 9TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-3903
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Country | US
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Telephone | 817-339-2300
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Fax | 817-339-2329
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Provider Business Mailing Address
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Address Line | 909 9TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-3903
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Country | US
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Telephone | 817-339-2300
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Fax | 817-339-2329
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Authorized Official
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Title or Position | VP
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Name | WILLIAM GREGORY SWINNEY
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Credential |
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Telephone | 972-789-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 000270
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License Number State | TX
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