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NPI Code Detail

MEDICARE: CENTRAL TEXAS DAY SURGERY CENTER LLC

MEDICARE: CENTRAL TEXAS DAY 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/Center130129TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
249004797OTHERTXPALMETTO GBA
3HH1256OTHERTXBLUE CROSS BLUE SHIELD
4490000381OTHERTXCARE

General Provider Information

NPI Number : 1962459610
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTRAL TEXAS DAY SURGERY CENTER LLC
Provider Business Mailing Address
First Line : PO BOX 11538
Second Line :
City : KILLEEN
State : TX
Zip : 76547-1538
Country : US
Telephone Number : 254-245-9177
Fax Number : 254-245-9178
Provider Business Practice Location Address
First Line : 3800 S W S YOUNG DR STE 204
Second Line :
City : KILLEEN
State : TX
Zip : 76542-3340
Country : US
Telephone Number : 254-245-9175
Fax Number : 254-213-7771
Authorized Official
Title or Position : PRESIDENT
Name : DR. SCOTT A IRVINE
Credential :
Telephone Number : 254-245-9175
Provider Enumeration Date : 05/28/2006
Last Update Date : 12/30/2024

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Directions to “CENTRAL TEXAS DAY SURGERY CENTER LLC ” Practice Location

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