Organization
MANSFIELD ENDOSCOPY CENTER, LLC
Active
Parent organization
GI ALLIANCE SURGERY CENTER, PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GI ALLIANCE SURGERY CENTER, PLLC
Authorized official
KELLY ROUVALDT (DIRECTOR OF ASC OPERATIONS)
(817) 415-9670
Entity
Organization
Contact information
Practice address
647 N MILLER RD, MANSFIELD, TX 76063-5820
(817) 893-2381
Mailing address
647 N MILLER RD, MANSFIELD, TX 76063-6083
(817) 415-9670
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
06/29/2022
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