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General NPI Number Information
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NPI Number | 1922255413
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Entity Type | Organization
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Legal Business Name | TWIN CITIES AMBULATORY SURGERY CENTER LP
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Dates
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Enumeration Date | 08/26/2008
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 1101 W. GANNON DR
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City | FESTUS
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State | MO
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Zip | 63028-2602
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Country | US
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Telephone | 636-931-5997
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Fax | 636-937-7968
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Provider Business Mailing Address
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Address Line | 14201 DALLAS PKWY
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City | DALLAS
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State | TX
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Zip | 75254-2916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHRISTPHER HARTSHORN
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Credential |
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Telephone | 314-800-2017
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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 | 223
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License Number State | MO
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