Provider Demographics
NPI:1992135354
Name:IHEART ASC DENTON, LLC
Entity type:Organization
Organization Name:IHEART ASC DENTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-244-9820
Mailing Address - Street 1:885 E COLLINS BLVD STE 109
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2270
Mailing Address - Country:US
Mailing Address - Phone:214-244-9820
Mailing Address - Fax:
Practice Address - Street 1:3304 COLORADO BLVD
Practice Address - Street 2:STE 202
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6871
Practice Address - Country:US
Practice Address - Phone:214-244-9820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical