Organization
LEGEND SURGICAL NETWORK
Active
Parent organization
SURGICAL ALLIANCE INCORPORATED
Organization subpart
Yes
Provider details
NPI number
Legal business name
SURGICAL ALLIANCE INCORPORATED
Authorized official
LISA NORTHCUTT (MANAGING MEMBER)
(817) 379-5600
Entity
Organization
Contact information
Practice address
1052 SUMMERPLACE LN, SOUTHLAKE, TX 76092-5120
(817) 379-5600
Mailing address
PO BOX 92592, SOUTHLAKE, TX 76092-0592
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
605077
TX
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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