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NPI Code Detail

MEDICARE: CENTRAL PARK SURGERY CENTER, LLC

MEDICARE: CENTRAL PARK SURGERY CENTER, LLC
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
1261QA1903XAmbulatory Surgical Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HH136AOTHERTXBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1376591156
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL PARK SURGERY CENTER, LLC
Provider Business Mailing Address
First Line : 411 CENTRAL PARK DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2069
Country : US
Telephone Number : 817-784-8300
Fax Number : 817-784-8301
Provider Business Practice Location Address
First Line : 411 CENTRAL PARK DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76014-2069
Country : US
Telephone Number : 817-784-8300
Fax Number : 817-784-8301
Authorized Official
Title or Position : CHIEF ADMINISTRATIVE OFFICER
Name : KRYSTAL SALAZAR
Credential :
Telephone Number : 817-784-8300
Provider Enumeration Date : 05/04/2006
Last Update Date : 08/21/2024

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Directions to “CENTRAL PARK SURGERY CENTER, LLC ” Practice Location

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