SOUTHLAKE SURGERY CENTER LLC NPI 1013218601

NPI Information

NPI: 1013218601
Provider Name: SOUTHLAKE SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
521 W SOUTHLAKE BLVD
SUITE 175
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 328-2100
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SOUTHLAKE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Southlake, TX. SOUTHLAKE SURGERY CENTER, LLC NPI is 1013218601. The provider is registered as an organization entity type.

The provider's business location address is:

521 W SOUTHLAKE BLVD
SUITE 175
SOUTHLAKE, TX
ZIP 76092-173
Phone: (817) 328-2100
Fax: (817) 328-2103

The provider's authorized official is Jonathan Heistein .
The authorized official title is Medical Director and has the following contact phone number (817) 328-2100.

The enumeration date for this NPI number is 11/12/2010 and was last updated on 11/12/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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