Provider Demographics
NPI:1851433718
Name:TEXAN AMBULATORY SURGERY CENTER
Entity Type:Organization
Organization Name:TEXAN AMBULATORY SURGERY CENTER
Other - Org Name:TEXAN SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-342-0900
Mailing Address - Street 1:7000 N MO PAC EXPY
Mailing Address - Street 2:STE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3027
Mailing Address - Country:US
Mailing Address - Phone:512-342-0900
Mailing Address - Fax:512-342-0809
Practice Address - Street 1:7000 N MO PAC EXPY
Practice Address - Street 2:STE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3027
Practice Address - Country:US
Practice Address - Phone:512-342-0900
Practice Address - Fax:512-342-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007965261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1519OtherBLUE CROSS BLUE SHEILD TX
TXASC176Medicare ID - Type Unspecified