Organization
AMBULATORY SURGICAL INSTITUTE OF DALLAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALLS (MANAGER)
(972) 234-4740
Entity
Organization
Contact information
Practice address
17051 DALLAS PARKWAY, SUITE 100, ADDISON, TX 75001
(469) 916-0521
(972) 234-0212
Mailing address
PO BOX 674348, DALLAS, TX 75267-4348
(469) 916-0521
(972) 234-0212
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
130152
TX
Other
Enumeration date
03/21/2013
Last updated
08/01/2013
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