Organization
GRACE AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADNAN SHAIKH (PRACTICE CONSULTANT)
(972) 331-9048
Entity
Organization
Contact information
Practice address
470 E STATE HIGHWAY 114, SOUTHLAKE, TX 76092-4406
(214) 450-9926
Mailing address
5995 SUMMERSIDE DR UNIT 797947, DALLAS, TX 75379-0219
(214) 390-7697
(972) 432-6692
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/15/2020
Last updated
05/13/2025
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