Provider Demographics
NPI:1881620995
Name:MCKINNEY SURGERY CENTER, LP
Entity type:Organization
Organization Name:MCKINNEY SURGERY CENTER, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF MCKINNEY SURGERY
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-217-0100
Mailing Address - Street 1:PO BOX 830956
Mailing Address - Street 2:DRAWER 1098
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0956
Mailing Address - Country:US
Mailing Address - Phone:214-217-0100
Mailing Address - Fax:214-217-0015
Practice Address - Street 1:8080 SH 121
Practice Address - Street 2:SUITE 100
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070
Practice Address - Country:US
Practice Address - Phone:214-547-2700
Practice Address - Fax:214-547-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008291261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXY50498Medicare UPIN
TX45C0001408Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID
TXASC280Medicare PIN