Provider Demographics
NPI:1609963768
Name:SURGERY CENTER OF RICHARDSON PHYSICIANS PARTNERSHIP LP
Entity Type:Organization
Organization Name:SURGERY CENTER OF RICHARDSON PHYSICIANS PARTNERSHIP LP
Other - Org Name:BAYLOR SURGICARE OF RICHARDSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:TITUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-389-7400
Mailing Address - Street 1:610 N COIT RD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5457
Mailing Address - Country:US
Mailing Address - Phone:972-331-9500
Mailing Address - Fax:972-331-9510
Practice Address - Street 1:610 N COIT RD
Practice Address - Street 2:SUITE 2120
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5457
Practice Address - Country:US
Practice Address - Phone:972-331-9500
Practice Address - Fax:972-331-9510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008037261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC188Medicare PIN
TX45C0001341Medicare Oscar/Certification