Provider Demographics
NPI:1205313848
Name:TS SURGERY CENTER LLC
Entity type:Organization
Organization Name:TS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BISHOY
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHREKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-415-8509
Mailing Address - Street 1:4847 W COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-1505
Mailing Address - Country:US
Mailing Address - Phone:210-432-0909
Mailing Address - Fax:210-432-2070
Practice Address - Street 1:4847 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-1505
Practice Address - Country:US
Practice Address - Phone:210-432-0909
Practice Address - Fax:210-432-2070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS SMILES DENTAL CENTER OF SAN ANTONIO, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25562261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental