Organization
BAYLOR SURGICARE AT ENNIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE L REED (AUTHORIZED OFFICIAL)
(972) 763-3859
Entity
Organization
Contact information
Practice address
2200 PHYSICANS BLVD, SUITE A, ENNIS, TX 75119-6247
(972) 875-5538
(972) 875-8530
Mailing address
2200 PHYSICANS BLVD, SUITE A, ENNIS, TX 75119-6247
(972) 875-5538
(972) 875-8530
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00936810
RAILROAD MEDICARE
TX
Enumeration date
12/14/2010
Last updated
08/19/2011
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