Organization
ENCORE ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY MARTIN (ADMIN)
(469) 215-3494
Entity
Organization
Contact information
Practice address
2200 PHYSICIANS BLVD STE A, ENNIS, TX 75119-6248
(972) 945-5800
(972) 846-6882
Mailing address
2200 PHYSICIANS BLVD STE 200, ENNIS, TX 75119-6247
(972) 945-5800
(972) 846-6882
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130516
ASC LICENSE
TX
Enumeration date
06/10/2020
Last updated
11/30/2021
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