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General NPI Number Information
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NPI Number | 1356542419
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Entity Type | Organization
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Legal Business Name | WINDHAVEN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 6160 WINDHAVEN PKWY STE 220
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 214-707-0985
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Fax | 888-525-3558
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Provider Business Mailing Address
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Address Line | 6160 WINDHAVEN PKWY STE 220
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 214-707-0985
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Fax | 888-525-3558
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Authorized Official
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Title or Position | CHIEF MANAGER
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Name | MS. DONNA DRERUP
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Credential |
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Telephone | 817-875-7336
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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 | APP #08498
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License Number State | TX
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