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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