Provider Demographics
NPI:1376729277
Name:BORGER SURGICAL ASSOC
Entity Type:Organization
Organization Name:BORGER SURGICAL ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-295-5050
Mailing Address - Street 1:13410 PRESTON RD
Mailing Address - Street 2:#C-425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5299
Mailing Address - Country:US
Mailing Address - Phone:214-295-5050
Mailing Address - Fax:214-295-5030
Practice Address - Street 1:9 MEDICAL PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7858
Practice Address - Country:US
Practice Address - Phone:214-295-5050
Practice Address - Fax:214-295-5030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2012-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5204208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81095Medicare UPIN