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Organization
PEDIATRIC AMBULATORY SURGERY CENTER SOUTHLAKE
Active
Organization
PEDIATRIC AMBULATORY SURGERY CENTER SOUTHLAKE
Active
Other names
Childrenshealth Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY LEE (VICE PRESIDENT OF ACCOUNTING)
(214) 456-0588
Entity
Organization
Contact information
Practice address
470 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-4406
(817) 730-5437
(817) 724-0010
Mailing address
470 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-4406
(817) 730-5437
(817) 724-0010
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/06/2015
Last updated
11/10/2015
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