GLENEAGLES SURGERY CENTER LLC NPI 1255000329

NPI Information

NPI: 1255000329
Provider Name: GLENEAGLES SURGERY CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 45D2290024

Address:
2633 DALLAS PKWY STE 100
PLANO, TX
ZIP 75093
Phone: (972) 403-7733
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GLENEAGLES SURGERY CENTER, LLC is an ambulatory surgical clinic center in Plano, TX. GLENEAGLES SURGERY CENTER, LLC NPI is 1255000329. The provider is registered as an organization entity type.

The provider's business location address is:

2633 DALLAS PKWY STE 100
PLANO, TX
ZIP 75093-715
Phone: (972) 403-7733
Fax: (972) 403-7744

The provider's authorized official is Jeremiah A Graff .
The authorized official title is Dpm and has the following contact phone number (142) 205-1078.

The CLIA number assigned to this NPI record is 45D2290024 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/10/2021 and was last updated on 9/10/2021.

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: 4/28/2024

NPI Synchronization or Removal

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