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General NPI Number Information
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NPI Number | 1437664406
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Entity Type | Organization
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Legal Business Name | MONTFORT SURGICAL CENTER LLC
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 5520 LBJ FWY STE 150
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City | DALLAS
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State | TX
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Zip | 75240-2313
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Country | US
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Telephone | 972-331-0718
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Fax |
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Provider Business Mailing Address
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Address Line | 5520 LBJ FWY STE 200
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City | DALLAS
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State | TX
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Zip | 75240-6381
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Country | US
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Telephone | 972-636-5727
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Fax | 972-408-0711
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Authorized Official
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Title or Position | OWNER
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Name | HAROON ILYAS RASHEED
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Credential | MD
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Telephone | 972-636-5727
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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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