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Organization
SELECT AMBULATORY SURGERY CENTER OF FT WORTH LLC
Active
Organization
SELECT AMBULATORY SURGERY CENTER OF FT WORTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY MCGILL (DIRECTOR OF NETWORK DEVELOPMENT)
(972) 215-7410
Entity
Organization
Contact information
Practice address
2001 COOPER ST, FT WORTH, TX 76104-2529
(817) 334-0990
Mailing address
PO BOX 674394, DALLAS, TX 75267-4394
(972) 479-1115
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130265
LICENSE
TX
Enumeration date
10/07/2015
Last updated
01/14/2016
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