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General NPI Number Information
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NPI Number | 1528604675
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER OF NORTH TEXAS, PLLC
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 330 STANDRIDGE BLVD
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City | ANNA
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State | TX
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Zip | 75409
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Country | US
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Telephone | 214-831-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 251 E SOUTHLAKE BLVD STE 110
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6298
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Country | US
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Telephone | 817-337-3433
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LYNN GIDDENS
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Credential |
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Telephone | 817-938-8803
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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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