Provider Demographics
NPI:1437664406
Name:MONTFORT SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:MONTFORT SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:ILYAS
Authorized Official - Last Name:RASHEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-636-5727
Mailing Address - Street 1:5520 LBJ FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6381
Mailing Address - Country:US
Mailing Address - Phone:972-636-5727
Mailing Address - Fax:972-408-0711
Practice Address - Street 1:5520 LBJ FWY STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-2313
Practice Address - Country:US
Practice Address - Phone:972-331-0718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical