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General NPI Number Information
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NPI Number | 1538354626
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Entity Type | Organization
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Legal Business Name | PLEXCARE SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 3345 WINTHROP AVE
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City | FORT WORTH
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State | TX
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Zip | 76116-5604
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Country | US
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Telephone | 817-834-8214
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Fax | 817-834-8900
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Provider Business Mailing Address
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Address Line | 6333 AIRPORT FWY SUITE 102
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City | FORT WORTH
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State | TX
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Zip | 76117-5323
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Country | US
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Telephone | 817-834-8214
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Fax | 817-834-8900
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Authorized Official
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Title or Position | ADIMISTRATOR
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Name | MR. MICHAEL BROWN
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Credential |
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Telephone | 817-834-8214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | E6734
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License Number State | TX
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