Provider Demographics
NPI:1528604675
Name:SURGERY CENTER OF NORTH TEXAS, PLLC
Entity Type:Organization
Organization Name:SURGERY CENTER OF NORTH TEXAS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDDENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-938-8803
Mailing Address - Street 1:251 E SOUTHLAKE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6298
Mailing Address - Country:US
Mailing Address - Phone:817-337-3433
Mailing Address - Fax:
Practice Address - Street 1:330 STANDRIDGE BLVD
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:TX
Practice Address - Zip Code:75409
Practice Address - Country:US
Practice Address - Phone:214-831-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical