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Organization
ADVANCED SURGICAL CONCEPTS LLC
Active
Organization
ADVANCED SURGICAL CONCEPTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA DANNA (AUTHORIZED OFICIAL)
(972) 763-3890
Entity
Organization
Contact information
Practice address
9118 BLUEBONNET CENTRE BLVD, BATON ROUGE, LA 70809-2975
(225) 368-2330
(225) 368-2275
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(225) 368-2322
(225) 368-2275
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
131
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053453134
NPI
LA
01
—
131
STATE LICENSE
LA
05
—
1507245
—
LA
01
—
P00147168
RAILROAD MEDICARE/SRRGA
—
Enumeration date
02/13/2007
Last updated
01/12/2021
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