Provider Demographics
NPI:1568883775
Name:FORT WORTH SURGICARE PARTNERS LTD
Entity Type:Organization
Organization Name:FORT WORTH SURGICARE PARTNERS LTD
Other - Org Name:BAYLOR SURGICAL HOSPITAL AT FORT WORTH OUTPATIENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENETHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3893
Mailing Address - Street 1:914 LIPSCOMB ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3169
Mailing Address - Country:US
Mailing Address - Phone:682-703-5770
Mailing Address - Fax:817-984-1625
Practice Address - Street 1:914 LIPSCOMB ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3169
Practice Address - Country:US
Practice Address - Phone:817-632-4534
Practice Address - Fax:817-632-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-16
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital