Provider Demographics
NPI:1689639262
Name:OAKWOOD SURGERY CENTER, LTD., LLP
Entity Type:Organization
Organization Name:OAKWOOD SURGERY CENTER, LTD., LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SWINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2877
Mailing Address - Street 1:16030 PARK VALLEY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3647
Mailing Address - Country:US
Mailing Address - Phone:512-246-8777
Mailing Address - Fax:512-246-8776
Practice Address - Street 1:16030 PARK VALLEY DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681
Practice Address - Country:US
Practice Address - Phone:512-246-8777
Practice Address - Fax:512-246-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000362261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX087940501Medicaid
TXASC009Medicare PIN