Organization
MEADOW LANE SURGICAL ALLIANCE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CLAVENNA (MANAGER)
(214) 378-3310
Entity
Organization
Contact information
Practice address
9301 N CENTRAL EXPY STE 400, DALLAS, TX 75231-0805
(210) 598-4262
Mailing address
1141 N LOOP 1604 E # 105-612, SAN ANTONIO, TX 78232-1339
(210) 598-4262
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
364SM0705X
Medical-Surgical Clinical Nurse Specialist
—
—
Other
Enumeration date
11/21/2017
Last updated
09/07/2023
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