Provider Demographics
NPI:1588993034
Name:NORTH TEXAS SURGERY CENTER LLC
Entity type:Organization
Organization Name:NORTH TEXAS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-438-4636
Mailing Address - Street 1:2430 VICTORY PARK LN APT 2401
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-7607
Mailing Address - Country:US
Mailing Address - Phone:972-438-4636
Mailing Address - Fax:214-260-1337
Practice Address - Street 1:2430 VICTORY PARK LN APT 2401
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-7607
Practice Address - Country:US
Practice Address - Phone:972-438-4636
Practice Address - Fax:214-260-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical