Organization
FIDELITY SURGICAL SUITES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M HOWINGTON CRNA (MEMBER)
(972) 743-2126
Entity
Organization
Contact information
Practice address
591 W MAIN ST, LEWISVILLE, TX 75057-3628
(972) 743-2126
(888) 770-6360
Mailing address
PO BOX 542618, GRAND PRAIRIE, TX 75054-2618
(972) 743-2126
(888) 770-6360
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000387
TX
Other
Enumeration date
01/23/2015
Last updated
01/28/2015
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