Provider Demographics
NPI:1003978115
Name:SURGERY CENTER OF GARLAND, LLC
Entity Type:Organization
Organization Name:SURGERY CENTER OF GARLAND, LLC
Other - Org Name:PRECISION SURGERY CENTER OF DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:THRASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-681-7723
Mailing Address - Street 1:12610 E NORTHWEST HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-8010
Mailing Address - Country:US
Mailing Address - Phone:972-681-7723
Mailing Address - Fax:972-682-3332
Practice Address - Street 1:12610 E NORTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-8010
Practice Address - Country:US
Practice Address - Phone:972-681-7723
Practice Address - Fax:972-682-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
TX008562261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205810901Medicaid
TX205810901Medicaid