Provider Demographics
NPI:1306920509
Name:LEWISVILLE SURGERY CENTER, LLC
Entity type:Organization
Organization Name:LEWISVILLE SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-420-0023
Mailing Address - Street 1:9720 COIT RD
Mailing Address - Street 2:STE. 220 # 336
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-5833
Mailing Address - Country:US
Mailing Address - Phone:972-420-0023
Mailing Address - Fax:888-770-6360
Practice Address - Street 1:591 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3628
Practice Address - Country:US
Practice Address - Phone:972-420-0023
Practice Address - Fax:888-770-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1525OtherBCBS
TX45C1237OtherMEDICARE