Provider Demographics
NPI:1124083076
Name:NORTH GARLAND SURGERY CENTER LLP
Entity type:Organization
Organization Name:NORTH GARLAND SURGERY CENTER LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-343-0832
Mailing Address - Street 1:7150 N GEORGE BUSH HWY
Mailing Address - Street 2:STE 101
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-2208
Mailing Address - Country:US
Mailing Address - Phone:214-703-1800
Mailing Address - Fax:214-703-1880
Practice Address - Street 1:7150 N GEORGE BUSH HWY
Practice Address - Street 2:STE 101
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-2208
Practice Address - Country:US
Practice Address - Phone:214-703-1800
Practice Address - Fax:214-703-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008192261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173680301Medicaid
TXP00221950OtherRAILROAD MEDICARE PTAN
TXASC255Medicare PIN
TX45C0001393Medicare Oscar/Certification