Provider Demographics
NPI:1376591156
Name:CENTRAL PARK SURGERY CENTER, L.P.
Entity Type:Organization
Organization Name:CENTRAL PARK SURGERY CENTER, L.P.
Other - Org Name:CENTRAL PARK SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-784-6673
Mailing Address - Street 1:411 CENTRAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2069
Mailing Address - Country:US
Mailing Address - Phone:817-784-8300
Mailing Address - Fax:817-784-8301
Practice Address - Street 1:411 CENTRAL PARK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2069
Practice Address - Country:US
Practice Address - Phone:817-784-8300
Practice Address - Fax:817-784-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH136AOtherBCBS PROVIDER NUMBER
TXASC305Medicare PIN