Organization
SOUTHPARK SURGERY CENTER, LLC
Active
Other names
Cardiovascular Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JARED LEGER (MANAGER)
(337) 274-6549
Entity
Organization
Contact information
Practice address
901 WILSON ST STE A, LAFAYETTE, LA 70503-2439
(512) 220-3824
Mailing address
13830 SAWYER RANCH RD STE 105, DRIPPING SPRINGS, TX 78620-5514
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
11/07/2017
Last updated
02/20/2020
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