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General NPI Number Information
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NPI Number | 1669569984
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Entity Type | Organization
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Legal Business Name | IRVING-COPPELL SURGICAL HOSPITAL LLP
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 400 WEST I-635 SUITE 101
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City | IRVING
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State | TX
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Zip | 75063-3842
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Country | US
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Telephone | 972-868-4000
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Fax | 972-868-4009
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Provider Business Mailing Address
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Address Line | 400 W LYNDON B JOHNSON FWY STE 101B
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City | IRVING
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State | TX
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Zip | 75063-3718
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Country | US
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Telephone | 972-868-4000
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Fax | 972-868-4009
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Authorized Official
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Title or Position | OFFICER/AUTHORIZED OFFICIAL
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Name | DONITA FLEMING
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Credential |
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Telephone | 202-815-3665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 007995
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License Number State | TX
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