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Organization

MAPLEWOOD AMBULATORY SURGERY CENTER, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK A WORKMAN M.D. (PRESIDENT)
(940) 696-8500
Entity
Organization

Contact information

Practice address
4301 MAPLEWOOD AVENUE, SUITE C, WICHITA FALLS, TX 76308
(940) 696-8548
(940) 696-8546
Mailing address
4301 MAPLEWOOD AVENUE, SUITE C, WICHITA FALLS, TX 76308-3879
(940) 696-8548
(940) 696-8546

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000388
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000388
TX STATE LICENSE #
TX
05
0879546-01
TX
Enumeration date
07/15/2006
Last updated
05/29/2018
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