Organization
FIRST COLONY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMAL OTULA (ADMINISTRATOR)
(972) 636-5727
Entity
Organization
Contact information
Practice address
600 FERRIS AVENUE, STE B, WAXAHACHIE, TX 75165-6246
(972) 636-5727
Mailing address
811 S CENTRAL EXPY STE 103, RICHARDSON, TX 75080-7439
(972) 636-5727
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/03/2016
Last updated
06/18/2024
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