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General NPI Number Information
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NPI Number | 1518841071
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Entity Type | Organization
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Legal Business Name | PARKSIDE GI SURGICENTER, LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 690 S LOOP 336 W STE 130
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City | CONROE
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State | TX
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Zip | 77304-3330
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Country | US
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Telephone | 936-760-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 690 S LOOP 336 W STE 130
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City | CONROE
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State | TX
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Zip | 77304-3330
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Country | US
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Telephone | 936-760-7660
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DAVID MCKNIGHT
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Credential |
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Telephone | 972-789-2816
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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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