MEDICARE: BELLAIRE OUTPATIENT SURGERY CENTER, LLP

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center	007890	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00090576	OTHER	TX	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	202158900	OTHER	US DEPT OF LABOR
2	HH1393	OTHER	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1275536328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLAIRE OUTPATIENT SURGERY CENTER, LLP

Provider Business Mailing Address
First Line	:	7200 OAKMONT BOULEVARD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3902
Country	:	US
Telephone Number	:	817-732-3300
Fax Number	:	817-732-0110

Provider Business Practice Location Address
First Line	:	7200 OAKMONT BOULEVARD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-3902
Country	:	US
Telephone Number	:	817-732-3300
Fax Number	:	817-732-0110

Authorized Official
Title or Position	:	OFFICER/AUTHORIZED OFFICIAL
Name	:	DONITA FLEMING
Credential	:
Telephone Number	:	202-381-3665

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/04/2024

7200 OAKMONT BLVD
FORT WORTH, TX
76132-3902

Practice Phone: 817-732-3300
Practice Fax: