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General NPI Number Information
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NPI Number | 1164478640
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 221 W COLORADO BLVD SUITE 100
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-943-8605
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Fax | 214-942-8463
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Provider Business Mailing Address
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Address Line | 221 W COLORADO BLVD SUITE 100
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City | DALLAS
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State | TX
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Zip | 75208-2363
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Country | US
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Telephone | 214-943-8605
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Fax | 214-948-9846
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CHERYL ROGERS
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Credential |
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Telephone | 214-943-8605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | E7053
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License Number State | TX
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