Organization
BAYLOR SURGICARE AT GRANBURY LLC
Active
Other names
Baylor Scott & White Surgicare-Granbury
Organization subpart
No
Provider details
NPI number
Authorized official
DONITA FLEMING (AUTHORIZED OFFICIAL)
(202) 815-3665
Entity
Organization
Contact information
Practice address
1717 PALUXY RD, GRANBURY, TX 76048-5667
(817) 579-8863
(817) 579-8872
Mailing address
1717 PALUXY RD, GRANBURY, TX 76048-5667
(817) 579-8863
(817) 579-8872
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
130006
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00724957
RAILROAD MEDICARE
TX
Enumeration date
01/26/2009
Last updated
10/04/2024
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