Provider Demographics
NPI:1336142413
Name:TEXAN AMBULATORY SURGERY CENTER, LP
Entity Type:Organization
Organization Name:TEXAN AMBULATORY SURGERY CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-343-0832
Mailing Address - Street 1:7000 N MOPAC EXPRESSWAY
Mailing Address - Street 2:STE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3030
Mailing Address - Country:US
Mailing Address - Phone:512-342-0900
Mailing Address - Fax:512-342-0808
Practice Address - Street 1:7000 N MOPAC EXPRESSWAY
Practice Address - Street 2:STE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3030
Practice Address - Country:US
Practice Address - Phone:512-342-0900
Practice Address - Fax:512-342-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007965261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX007965OtherSTATE ASC LICENSE NUMBER
TX0879769Medicaid
TXHH1519OtherBLUE CROSS BLUE SHIELD
TXASC176Medicare PIN
TX0879769Medicaid