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NPI 1700546629

NPI 1700546629 : STONE OAK SURGICENTER, LLC : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1700546629
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    Entity Type          |    Organization 
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    Legal Business Name  |    STONE OAK SURGICENTER, LLC 
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Dates
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    Enumeration Date     |    12/20/2021
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    Last Update Date     |    12/20/2021
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Provider Practice Location Address
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    Address Line         |    123 N LOOP 1604 E STE 107 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-1390
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    Country              |    US
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    Telephone            |    210-267-1374
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    123 N LOOP 1604 E STE 107 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78232-1390
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    Country              |    US
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    Telephone            |    210-267-1374
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VP
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    Name                 |     WILLIAM G SWINNEY 
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    Credential           |    
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    Telephone            |    972-789-2877
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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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