Provider Demographics
NPI:1851650428
Name:TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE
Entity Type:Organization
Organization Name:TEXAS HEALTH OUTPATIENT SURGERY CENTER ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SALSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-236-6485
Mailing Address - Street 1:10840 TEXAS HEALTH TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6846
Mailing Address - Country:US
Mailing Address - Phone:682-236-3000
Mailing Address - Fax:
Practice Address - Street 1:10840 TEXAS HEALTH TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-6846
Practice Address - Country:US
Practice Address - Phone:682-212-5100
Practice Address - Fax:817-693-2510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103128261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316285101Medicaid
TXHH259AOtherBCBSA
TXHH259AOtherBCBSA