Provider Demographics
NPI:1245759356
Name:DALLAS ASC, LLC
Entity Type:Organization
Organization Name:DALLAS ASC, LLC
Other - Org Name:NORTH PARK HEART & VASCULAR SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BEMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-504-5667
Mailing Address - Street 1:DEPT# 6015
Mailing Address - Street 2:PO BOX 4417
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4417
Mailing Address - Country:US
Mailing Address - Phone:610-644-8900
Mailing Address - Fax:484-924-0053
Practice Address - Street 1:11970 N CENTRAL EXPY STE 610
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3768
Practice Address - Country:US
Practice Address - Phone:469-232-9393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-11
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical