CLEBURNE SURGICAL CENTER LLC NPI 1619093218

NPI Information

NPI: 1619093218
Provider Name: CLEBURNE SURGICAL CENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 45D0675058

Address:
2010 W KATHERINE P RAINES
CLEBURNE, TX
ZIP 76031
Phone: (817) 645-0811
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CLEBURNE SURGICAL CENTER, LLC is an ambulatory surgical clinic center in Cleburne, TX. CLEBURNE SURGICAL CENTER, LLC NPI is 1619093218. The provider is registered as an organization entity type.

The provider's business location address is:

2010 W KATHERINE P RAINES
CLEBURNE, TX
ZIP 76031
Phone: (817) 645-0811

The provider's authorized official is Catherine K Kowalski .
The authorized official title is Coo and has the following contact phone number (615) 301-8140.

The CLIA number assigned to this NPI record is 45D0675058 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 9/5/2012.

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	008560	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	008560	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: 4/28/2024

NPI Synchronization or Removal

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