Organization
LEGENT HILL COUNTRY ASC, LLC
Active
Other names
Legent Hill Country ASC
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN FOWLER (CEO)
(917) 216-6285
Entity
Organization
Contact information
Practice address
811 S. MILAM STREET, FREDERICKSBURG, TX 78624
(817) 421-1066
Mailing address
4090 MAPLESHADE LN STE 220, PLANO, TX 75093-0026
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2024
Last updated
02/07/2024
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