Organization
SPICEWOOD SURGERY CENTER LLC
Active
Other names
Spicewood Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH RN (AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
13617 CALDWELL DR STE 200, AUSTIN, TX 78750-2324
(512) 637-5563
Mailing address
13617 CALDWELL DR STE 200, AUSTIN, TX 78750-2324
(512) 637-5563
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083176309
NPI
TX
Enumeration date
04/04/2019
Last updated
11/20/2024
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