Basic Information
| Provider Information | |||||||||
| NPI: | 1396023172 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STARWOOD SURGERY INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 938 | ||||||||
| Address2: | |||||||||
| City: | ROWLETT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750300938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142272457 | ||||||||
| FaxNumber: | 9724637247 | ||||||||
| Practice Location | |||||||||
| Address1: | 6898 LEBANON RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750347473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142272457 | ||||||||
| FaxNumber: | 9724637247 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2011 | ||||||||
| LastUpdateDate: | 07/28/2011 | ||||||||
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| AuthorizedOfficialLastName: | SMART | ||||||||
| AuthorizedOfficialFirstName: | ANGIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2142272457 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.