Provider Demographics
NPI:1972878726
Name:WILSON CREEK SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:WILSON CREEK SURGICAL CENTER, LLC
Other - Org Name:STONEBRIDGE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALYER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:972-632-3800
Mailing Address - Street 1:8855 SYNERGY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-6503
Mailing Address - Country:US
Mailing Address - Phone:972-632-3800
Mailing Address - Fax:972-632-3801
Practice Address - Street 1:8855 SYNERGY DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6503
Practice Address - Country:US
Practice Address - Phone:972-632-3800
Practice Address - Fax:972-632-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical