Provider Demographics
NPI:1922542745
Name:NORTH TEXAS SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:NORTH TEXAS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SREENADHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:VATTAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-965-3023
Mailing Address - Street 1:1001 SARA SWAMY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-3120
Mailing Address - Country:US
Mailing Address - Phone:903-965-3023
Mailing Address - Fax:903-965-3028
Practice Address - Street 1:1001 SARA SWAMY DR STE 200
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-3120
Practice Address - Country:US
Practice Address - Phone:903-965-3023
Practice Address - Fax:903-965-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical