Provider Demographics
NPI:1578641528
Name:SHERMAN SURGERY CENTER
Entity Type:Organization
Organization Name:SHERMAN SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PONNUSWAMY
Authorized Official - Middle Name:T
Authorized Official - Last Name:SWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-893-6311
Mailing Address - Street 1:1111 SARA SWAMY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-1779
Mailing Address - Country:US
Mailing Address - Phone:903-893-6311
Mailing Address - Fax:903-870-0456
Practice Address - Street 1:1111 SARA SWAMY DR
Practice Address - Street 2:SUITE B
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1779
Practice Address - Country:US
Practice Address - Phone:903-893-6311
Practice Address - Fax:903-870-0456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SWAMYCLINIC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-01
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8285261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC304Medicare PIN