Provider Demographics
NPI:1962774653
Name:KING SURGICAL CONSULTANTS LLC
Entity type:Organization
Organization Name:KING SURGICAL CONSULTANTS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-857-6853
Mailing Address - Street 1:PO BOX 612142
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-2142
Mailing Address - Country:US
Mailing Address - Phone:877-857-6853
Mailing Address - Fax:877-857-6853
Practice Address - Street 1:1778 N PLANO RD
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-1968
Practice Address - Country:US
Practice Address - Phone:877-857-6853
Practice Address - Fax:877-857-6853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies