Provider Demographics
NPI:1225574098
Name:STONEBRIAR SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:STONEBRIAR SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MEINTJES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-377-2625
Mailing Address - Street 1:8380 WARREN PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4198
Mailing Address - Country:US
Mailing Address - Phone:972-377-2625
Mailing Address - Fax:972-377-2667
Practice Address - Street 1:8380 WARREN PKWY
Practice Address - Street 2:STE 201
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4198
Practice Address - Country:US
Practice Address - Phone:972-377-2625
Practice Address - Fax:972-377-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical