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General NPI Number Information
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NPI Number | 1093120859
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Entity Type | Organization
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Legal Business Name | PARK HILL SURGERY CENTER, LLC
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Dates
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Enumeration Date | 06/30/2014
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 3455 LOCKE AVE STE 100
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City | FORT WORTH
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State | TX
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Zip | 76107-5745
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Country | US
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Telephone | 817-585-1900
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Fax | 817-585-1899
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Provider Business Mailing Address
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Address Line | 3455 LOCKE AVE SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76107-5745
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Country | US
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Telephone | 817-585-1900
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Fax | 817-585-1899
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Authorized Official
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Title or Position | BOARD CHAIRMAN
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Name | JAWAD QURESHI
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Credential | MD
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Telephone | 817-773-0293
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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 |
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License Number State |
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