Provider Demographics
NPI:1154566578
Name:WOMEN'S SPECIALTY SURGERY CENTER OF DALLAS, LLC
Entity type:Organization
Organization Name:WOMEN'S SPECIALTY SURGERY CENTER OF DALLAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:D
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-345-6752
Mailing Address - Street 1:8230 WALNUT HILL LANE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231
Mailing Address - Country:US
Mailing Address - Phone:214-345-6747
Mailing Address - Fax:214-345-6748
Practice Address - Street 1:8230 WALNUT HILL LANE
Practice Address - Street 2:SUITE #101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-345-6747
Practice Address - Fax:214-345-6748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical