Provider Demographics
NPI:1649587338
Name:TEXAS CLINIC SURGERY CENTER LLC
Entity Type:Organization
Organization Name:TEXAS CLINIC SURGERY CENTER LLC
Other - Org Name:TEXAS CLINIC SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIGHTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-739-3001
Mailing Address - Street 1:6957 W PLANO PKWY STE 2000
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-1623
Mailing Address - Country:US
Mailing Address - Phone:972-820-9033
Mailing Address - Fax:972-820-9034
Practice Address - Street 1:6957 W PLANO PKWY STE 2000
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-1623
Practice Address - Country:US
Practice Address - Phone:972-820-9033
Practice Address - Fax:972-820-9034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-02
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008600261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical