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NPI Code Detail

MEDICARE: PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP

MEDICARE: PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP
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/Center008533TX

General Provider Information

NPI Number : 1992901847
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP
Provider Business Mailing Address
First Line : 2001 COOPER ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2529
Country : US
Telephone Number : 817-529-2620
Fax Number : 817-877-1292
Provider Business Practice Location Address
First Line : 2001 COOPER ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2529
Country : US
Telephone Number : 817-529-2620
Fax Number : 817-877-1292
Authorized Official
Title or Position : MEDICARE AUTHORIZED OFFICIAL
Name : KATHERINE L. REED
Credential :
Telephone Number : 972-763-3859
Provider Enumeration Date : 06/26/2007
Last Update Date : 12/22/2014

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