Organization
PPG SPECIAL PROCEDURES, LLC
Active
Other names
PPG Surgical Procedures - Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAVANAN BALAMUTHUSAMY MD (SOLE MEMBER)
(817) 870-2616
Entity
Organization
Contact information
Practice address
500 LIPSCOMB ST, FORT WORTH, TX 76104-2239
(817) 870-2616
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7990
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
05/03/2023
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