MEDICARE: NSPC SURGERY CENTER OF TEXAS 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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1396442067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NSPC SURGERY CENTER OF TEXAS LLC

Provider Business Mailing Address
First Line	:	11350 MCCORMICK RD.
Second Line	:	EXECUTIVE PLAZA 1 SUITE 501
City	:	HUNT VALLEY
State	:	MD
Zip	:	21031-1002
Country	:	US
Telephone Number	:	694-205-7297
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 GREENVILLE AVE STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5186
Country	:	US
Telephone Number	:	469-205-7297
Fax Number	:

Authorized Official
Title or Position	:	ASC ADMINISTRATOR
Name	:	HILLARY JONES
Credential	:	RN
Telephone Number	:	469-205-7297

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	05/10/2023

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