Organization
MOOREFIELD PARK ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ROUVALDT (SR. DIRECTOR OF ASC COMPLIANCE)
(817) 893-2381
Entity
Organization
Contact information
Practice address
800 MOOREFIELD PARK DR STE 100, NORTH CHESTERFIELD, VA 23236-3686
(817) 893-2381
Mailing address
550 RESERVE ST STE 550, SOUTHLAKE, TX 76092-1604
(817) 893-2381
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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