MEDICARE: LEWISVILLE SURGICARE PARTNERS, LTD

Medicare Provider Information

Scope of Practice

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	007876	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	490005533	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1326042300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEWISVILLE SURGICARE PARTNERS, LTD

Provider Business Mailing Address
First Line	:	1854 LAKEPOINTE DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-6442
Country	:	US
Telephone Number	:	972-315-1401
Fax Number	:	972-315-9242

Provider Business Practice Location Address
First Line	:	1854 LAKEPOINTE DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-6442
Country	:	US
Telephone Number	:	972-315-1401
Fax Number	:	972-315-9242

Authorized Official
Title or Position	:	OFFICER/MEDICARE AUTHORIZED OFFICIA
Name	:	KATHERINE L. REED
Credential	:
Telephone Number	:	972-763-3859

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	09/25/2014

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