Provider Demographics
NPI:1720020472
Name:DENTON SURGERY CENTER LLC
Entity Type:Organization
Organization Name:DENTON SURGERY CENTER LLC
Other - Org Name:TEXAS HEALTH SURGERY CENTER DENTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-383-7100
Mailing Address - Street 1:2515 SCRIPTURE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2311
Mailing Address - Country:US
Mailing Address - Phone:940-383-7100
Mailing Address - Fax:940-383-7110
Practice Address - Street 1:2515 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2311
Practice Address - Country:US
Practice Address - Phone:940-383-7100
Practice Address - Fax:940-383-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1823261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1848657-01Medicaid
TX184865701Medicaid
TX184865701Medicaid
TXASC293Medicare PIN