Provider Demographics
NPI:1245384981
Name:TP SPECIALTY SURGERY CENTER LP
Entity Type:Organization
Organization Name:TP SPECIALTY SURGERY CENTER LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-389-7400
Mailing Address - Street 1:630 N COIT RD
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3700
Mailing Address - Country:US
Mailing Address - Phone:214-389-7362
Mailing Address - Fax:214-389-7350
Practice Address - Street 1:8122 DATAPOINT DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3272
Practice Address - Country:US
Practice Address - Phone:210-293-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008361261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX275098Medicare PIN
TX45C0001425Medicare ID - Type UnspecifiedMEDICARE