Provider Demographics
NPI:1598390015
Name:CHRISTUS SURGERY CENTER VILLAGES LLC
Entity Type:Organization
Organization Name:CHRISTUS SURGERY CENTER VILLAGES LLC
Other - Org Name:CHRISTUS SURGERY CENTER - SHREVEPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRPERSON OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:RUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-282-2637
Mailing Address - Street 1:385 BERT KOUNS INDUSTRIAL LOOP STE 300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8158
Mailing Address - Country:US
Mailing Address - Phone:318-212-0552
Mailing Address - Fax:318-212-0557
Practice Address - Street 1:385 BERT KOUNS INDUSTRIAL LOOP STE 300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-8158
Practice Address - Country:US
Practice Address - Phone:318-212-0552
Practice Address - Fax:318-212-0557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical