Basic Information
| Provider Information | |||||||||
| NPI: | 1205390085 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TWIN CREEKS SURGERY CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5999 CUSTER RD STE 110-520 | ||||||||
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| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750359302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728728254 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2023 W MCDERMOTT DR STE 240 | ||||||||
| Address2: | |||||||||
| City: | ALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750134679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723302696 | ||||||||
| FaxNumber: | 9728507352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2019 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| AuthorizedOfficialLastName: | BARNES | ||||||||
| AuthorizedOfficialFirstName: | SHANNON | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 9728728254 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.