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General NPI Number Information
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NPI Number | 1912930959
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Entity Type | Organization
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Legal Business Name | TOMBALL SURGERY CENTER, LP
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 24727 TOMBALL PARKWAY
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City | TOMBALL
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State | TX
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Zip | 77375
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Country | US
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Telephone | 281-255-5300
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Fax | 281-255-5330
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Provider Business Mailing Address
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Address Line | 9301 N CENTRAL EXPY TOWER II STE 360
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City | DALLAS
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State | TX
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Zip | 75231-0806
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Country | US
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Telephone | 214-217-0100
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Fax | 214-217-0015
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Authorized Official
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Title or Position | MANAGER OF TOMBALL SURGERY, LLC
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Name | WAYNE F SPARKS
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Credential |
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Telephone | 214-217-0100
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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 | 008325
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License Number State | TX
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