Organization
SOUTHWEST VASCULAR AND SURGICAL GROUP
Active
Other names
Dallas Surgical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TANYA S. GREEN (PRACTICE MANAGER)
(972) 566-8039
Entity
Organization
Contact information
Practice address
7777 FOREST LANE, SUITE C-760, DALLAS, TX 75230-6801
(972) 566-8039
(972) 566-2312
Mailing address
7777 FOREST LANE, SUITE C-760, DALLAS, TX 75230-6801
(972) 566-8039
(972) 566-2312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E6012
TX
208600000X
Surgery Physician
J0020
TX
208600000X
Surgery Physician
J3706
TX
208600000X
Surgery Physician
K9914
TX
2086S0129X
Vascular Surgery Physician
L3839
TX
2086X0206X
Surgical Oncology Physician
H2239
TX
208C00000X
Colon & Rectal Surgery Physician
E3311
TX
208C00000X
Colon & Rectal Surgery Physician
K7546
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
083607401
—
TX
Enumeration date
01/02/2007
Last updated
03/30/2009
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