Provider Demographics
NPI:1922075167
Name:NORTH CENTRAL METHODIST ASC, LP
Entity Type:Organization
Organization Name:NORTH CENTRAL METHODIST ASC, LP
Other - Org Name:METHODIST AMBULATORY SURGERY CENTER NORTH CENTRAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-575-0238
Mailing Address - Street 1:19010 STONE OAK PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3225
Mailing Address - Country:US
Mailing Address - Phone:210-575-5200
Mailing Address - Fax:210-575-5222
Practice Address - Street 1:19010 STONE OAK PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3225
Practice Address - Country:US
Practice Address - Phone:210-575-5200
Practice Address - Fax:210-575-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007843261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1569OtherBLUE CROSS BLUE SHIELD
TX49053102OtherPALMETTO GBA