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General NPI Number Information
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NPI Number | 1427626696
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Entity Type | Organization
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Legal Business Name | RADIANT SURGICAL SPECIALISTS OF NORTH TEXAS PLLC
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 1105 CENTRAL EXPY N STE 2350
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City | ALLEN
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State | TX
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Zip | 75013-6116
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Country | US
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Telephone | 972-767-5841
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2017
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City | ALLEN
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State | TX
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Zip | 75013-0034
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Country | US
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Telephone | 828-273-6113
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Fax |
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Authorized Official
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Title or Position | MD, OWNER
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Name | SARAH KIM
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Credential |
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Telephone | 828-273-6113
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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 |
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License Number State |
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