Provider Demographics
NPI:1245798826
Name:SURGCENTER OF GREATER DALLAS, LLC.
Entity Type:Organization
Organization Name:SURGCENTER OF GREATER DALLAS, LLC.
Other - Org Name:SURGCENTER OF GREATER DALLAS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:469-400-3311
Mailing Address - Street 1:11411 E NORTHWEST HWY STE 220
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-1437
Mailing Address - Country:US
Mailing Address - Phone:469-214-4344
Mailing Address - Fax:
Practice Address - Street 1:11411 E NORTHWEST HWY STE 220
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-1437
Practice Address - Country:US
Practice Address - Phone:469-563-8932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical