Organization
BAYLOR SURGICARE AT NORTH DALLAS, LLC
Active
Other names
Baylor Scott & White Surgicare-North Dallas
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BLACH (OFFICER, AUTHORIZED OFFICIAL)
(713) 343-0832
Entity
Organization
Contact information
Practice address
12230 COIT RD, STE 200, DALLAS, TX 75251-2322
(469) 374-6400
(469) 374-6419
Mailing address
14201 DALLAS PKWY, DALLAS, TX 75254-2916
(469) 374-6400
(469) 374-6419
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
007298
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085920901
—
TX
01
—
490005465
RAILROAD MEDICARE
TX
05
—
Z04511337
—
TX
Enumeration date
04/21/2006
Last updated
10/04/2024
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