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Organization
MOOREFIELD PARK ENDOSCOPY CENTER, LLC
Active
Organization
MOOREFIELD PARK ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ROUVALDT (SR. DIRECTOR OF ASC COMPLIANCE)
(817) 893-2381
Entity
Organization
Contact information
Practice address
800 MOOREFIELD PARK DR STE 100, NORTH CHESTERFIELD, VA 23236-3686
(817) 893-2381
Mailing address
550 RESERVE ST STE 550, SOUTHLAKE, TX 76092-1604
(817) 893-2381
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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