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Organization
PREMIER ENDOSCOPY ASC, LLC
Active
Organization
PREMIER ENDOSCOPY ASC, LLC
Active
Other names
Premier Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA MORAN (AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
2563 S VAL VISTA DR, SUITE 101, GILBERT, AZ 85295-1804
(480) 786-6655
Mailing address
15305 DALLAS PKWY, SUITE 1600, ADDISON, TX 75001-4637
(972) 763-3893
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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