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Organization

UROLOGICAL SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES BAMBERGER DIRECTOR (DIRECTOR)
(817) 229-4222
Entity
Organization

Contact information

Practice address
418 S HENDERSON ST, FORT WORTH, TX 76104-1017
(817) 870-9165
(817) 870-9165
Mailing address
PO BOX 1958, FORT WORTH, TX 76101
(817) 229-4222

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085925801
TX
Enumeration date
08/26/2006
Last updated
07/21/2022
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