REDBIRD SQUARE ENDOSCOPY CENTER LLC NPI 1114996774

NPI Information

NPI: 1114996774
Provider Name: REDBIRD SQUARE ENDOSCOPY CENTER LLC

Doing Business As: DIGESTIVE HEALTH CENTER AT REDBIRD SQUARE

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
3107 W CAMP WISDOM RD STE 189
DALLAS, TX
ZIP 75237
Phone: (214) 331-2922
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REDBIRD SQUARE ENDOSCOPY CENTER LLC is an ambulatory surgical clinic center in Dallas, TX. REDBIRD SQUARE ENDOSCOPY CENTER LLC NPI is 1114996774. The provider is registered as an organization entity type.
The provider Is Doing Business As Digestive Health Center At Redbird Square.

The provider's business location address is:

3107 W CAMP WISDOM RD STE 189
DALLAS, TX
ZIP 75237-638
Phone: (214) 331-2922
Fax: (214) 331-0413

The provider's authorized official is Wendel M Wainner .
The authorized official title is Vice President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 45D0960875 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/16/2006 and was last updated on 10/19/2020.

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	007032	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	087966001	MEDICAID	TEXAS

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: 11/14/2023

NPI Synchronization or Removal

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