Provider Demographics
NPI:1891776605
Name:TEXAS ENDOSCOPY LLC
Entity Type:Organization
Organization Name:TEXAS ENDOSCOPY LLC
Other - Org Name:TEXAS ENDOSCOPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-473-9292
Mailing Address - Street 1:6405 W PARKER RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8143
Mailing Address - Country:US
Mailing Address - Phone:972-473-9292
Mailing Address - Fax:972-608-0127
Practice Address - Street 1:6405 W PARKER RD
Practice Address - Street 2:SUITE 370
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8143
Practice Address - Country:US
Practice Address - Phone:972-473-9292
Practice Address - Fax:972-608-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007210261QE0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1523OtherBCBS
TXHH1523OtherBCBS