Organization
NORTH CAMPUS SURGERY CENTER LLC
Active
Other names
North Campus Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER/AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
633 EMERSON RD, #120, CREVE COEUR, MO 63141-6739
(314) 991-9922
(314) 991-6794
Mailing address
15305 DALLAS PKWY STE 1600, ADDISON, TX 75001-6491
(972) 763-3893
(972) 692-6745
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
264-0
MO
261QA1903X
Ambulatory Surgical Clinic/Center
TBD
MO
Other
Enumeration date
07/17/2015
Last updated
08/13/2019
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