Provider Demographics
NPI:1982607446
Name:DENTON SURGICARE PARTNERS, LTD.
Entity Type:Organization
Organization Name:DENTON SURGICARE PARTNERS, LTD.
Other - Org Name:DENTON SURGICARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL VP
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:EXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:VP
Authorized Official - Phone:940-323-1393
Mailing Address - Street 1:350 S INTERSTATE 35 E
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-5376
Mailing Address - Country:US
Mailing Address - Phone:940-323-1393
Mailing Address - Fax:940-320-0309
Practice Address - Street 1:350 S INTERSTATE 35 E
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-5376
Practice Address - Country:US
Practice Address - Phone:940-323-1393
Practice Address - Fax:940-320-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7012261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZOASC0642Medicaid
TXZOASC0642Medicaid