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General NPI Number Information
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NPI Number | 1376650911
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Entity Type | Organization
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Legal Business Name | ELM PLACE AMBULATORY SURGICAL CENTER
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 2217 S DANVILLE DR
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City | ABILENE
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State | TX
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Zip | 79605-4719
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Country | US
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Telephone | 325-695-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 2217 S DANVILLE DR
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City | ABILENE
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State | TX
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Zip | 79605-4719
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Country | US
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Telephone | 325-695-0600
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | AUSTIN I KING
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Credential | M.D.
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Telephone | 325-695-0600
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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 | 0166
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License Number State | TX
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