Organization
WARNER PARK SURGERY CENTER LLC
Active
Other names
Center for Advanced Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/ AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
3367 S. MERCY ROAD, SUITE 101, GILBERT, AZ 85297
(480) 899-2571
(480) 899-4263
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(480) 899-2571
(480) 899-4263
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC0041
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490004250
RAILROAD MEDICARE
AZ
05
—
628076
—
AZ
Enumeration date
04/24/2006
Last updated
10/24/2024
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