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General NPI Number Information
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NPI Number | 1346576790
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN WOMEN'S SURGERY CENTER
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 8616 GREENVILLE AVE SUITE 101
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City | DALLAS
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State | TX
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Zip | 75243-7146
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Country | US
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Telephone | 214-742-9310
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Fax | 214-969-9468
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Provider Business Mailing Address
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Address Line | 8616 GREENVILLE AVE SUITE 101
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City | DALLAS
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State | TX
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Zip | 75243-7146
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Country | US
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Telephone | 214-742-9310
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Fax | 214-969-9468
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. JENNI BEAVER
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Credential |
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Telephone | 214-742-9310
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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 | 130019
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License Number State | TX
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