Provider Demographics
NPI:1356080642
Name:LEGENT OUTPATIENT SURGERY SINGING HILLS, LLC
Entity Type:Organization
Organization Name:LEGENT OUTPATIENT SURGERY SINGING HILLS, LLC
Other - Org Name:LEGENT OUTPATIENT SURGERY SINGING HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-216-6285
Mailing Address - Street 1:524 SINGING OAKS
Mailing Address - Street 2:STE 101
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070
Mailing Address - Country:US
Mailing Address - Phone:830-326-4099
Mailing Address - Fax:830-327-0078
Practice Address - Street 1:524 SINGING OAKS STE 101
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6532
Practice Address - Country:US
Practice Address - Phone:830-326-4099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical