Provider Demographics
NPI:1326494188
Name:SOUTH AUSTIN SURGICENTER, LLC
Entity Type:Organization
Organization Name:SOUTH AUSTIN SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SWINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2877
Mailing Address - Street 1:4207 JAMES CASEY ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3300
Mailing Address - Country:US
Mailing Address - Phone:512-440-7894
Mailing Address - Fax:
Practice Address - Street 1:4207 JAMES CASEY ST
Practice Address - Street 2:SUITE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3300
Practice Address - Country:US
Practice Address - Phone:512-440-7894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical