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General NPI Number Information
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NPI Number | 1205390085
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Entity Type | Organization
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Legal Business Name | TWIN CREEKS SURGERY CENTER LLC
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Dates
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Enumeration Date | 01/26/2019
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 2023 W MCDERMOTT DR STE 240
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City | ALLEN
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State | TX
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Zip | 75013-4679
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Country | US
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Telephone | 972-330-2696
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Fax | 972-850-7352
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Provider Business Mailing Address
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Address Line | 5999 CUSTER RD STE 110-520
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City | FRISCO
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State | TX
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Zip | 75035-9302
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Country | US
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Telephone | 972-872-8254
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | SHANNON BARNES
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Credential |
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Telephone | 972-872-8254
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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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