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NPI Code Detail

MEDICARE: THE PALLADIUM FOR SURGERY DALLAS LTD

MEDICARE: THE PALLADIUM FOR SURGERY DALLAS 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
1261QA1903XAmbulatory Surgical Clinic/Center70064187TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1008323OTHERTXTX DEPT OF STATE HEALTH S

General Provider Information

NPI Number : 1932259231
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE PALLADIUM FOR SURGERY DALLAS LTD
Provider Business Mailing Address
First Line : 5920 FOREST PARK RD
Second Line : SUITE 700
City : DALLAS
State : TX
Zip : 75235-6411
Country : US
Telephone Number : 214-350-2400
Fax Number : 214-352-4862
Provider Business Practice Location Address
First Line : 5920 FOREST PARK RD
Second Line : SUITE 700
City : DALLAS
State : TX
Zip : 75235-6411
Country : US
Telephone Number : 214-350-2400
Fax Number : 214-352-4862
Authorized Official
Title or Position : BUSINESS OFFICE SUPERVISOR
Name : KIMBERLY BURTON
Credential :
Telephone Number : 214-350-2400
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/20/2007

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Directions to “THE PALLADIUM FOR SURGERY DALLAS LTD ” Practice Location

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