Provider Demographics
NPI:1164582649
Name:STRICTLY PEDIATRICS SURGERY CENTER OF CENTRAL TEXAS, LLC
Entity Type:Organization
Organization Name:STRICTLY PEDIATRICS SURGERY CENTER OF CENTRAL TEXAS, LLC
Other - Org Name:STRICTLY PEDIATRICS SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-474-7337
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:512-474-7337
Mailing Address - Fax:512-474-7336
Practice Address - Street 1:1301 BARBARA JORDAN BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723
Practice Address - Country:US
Practice Address - Phone:512-474-7337
Practice Address - Fax:512-474-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical