Provider Demographics
NPI:1821302621
Name:SURGICARE PHYSICIANS TEXAS PA
Entity Type:Organization
Organization Name:SURGICARE PHYSICIANS TEXAS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-389-7380
Mailing Address - Street 1:630 N COIT RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3764
Mailing Address - Country:US
Mailing Address - Phone:214-389-7400
Mailing Address - Fax:214-389-7350
Practice Address - Street 1:630 N COIT RD STE 2200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3764
Practice Address - Country:US
Practice Address - Phone:214-389-7400
Practice Address - Fax:214-389-7350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty