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General NPI Number Information
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NPI Number | 1891947057
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSISTANCE OF GREATER DALLAS, LLC.
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 3021 RIDGE RD SUITE A 231
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City | ROCKWALL
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State | TX
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Zip | 75032-5806
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Country | US
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Telephone | 214-507-9306
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Fax | 469-338-5928
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Provider Business Mailing Address
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Address Line | 3021 RIDGE RD SUITE A 231
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City | ROCKWALL
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State | TX
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Zip | 75032-5806
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Country | US
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Telephone | 214-507-9306
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Fax | 469-338-5928
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Authorized Official
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Title or Position | OWNER
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Name | CODY LYNN DAY
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Credential | L.S.A.
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Telephone | 214-507-9306
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number | 00036
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License Number State | TX
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