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Organization

WALNUT HILL SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RYAN NICKS (CFO)
(720) 524-1001
Entity
Organization

Contact information

Practice address
5494 GLEN LAKES DR, DALLAS, TX 75231-4308
(214) 692-6220
(214) 696-1579
Mailing address
3900 E MEXICO AVE STE 102, DENVER, CO 80210-3941
(303) 800-2078
(303) 800-2078

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
261QS0132X
Ophthalmologic Surgery Clinic/Center
008040
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
165322201
TX
Enumeration date
05/16/2006
Last updated
10/29/2019
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