Basic Information
| Provider Information | |||||||||
| NPI: | 1912948845 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICIANS SURGICAL HOSPITALS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6819 PLUM CREEK DR | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791241602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063546100 | ||||||||
| FaxNumber: | 8063546101 | ||||||||
| Practice Location | |||||||||
| Address1: | 6819 PLUM CREEK DR | ||||||||
| Address2: | |||||||||
| City: | AMARILLO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 791241602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8063546100 | ||||||||
| FaxNumber: | 8063546101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2006 | ||||||||
| LastUpdateDate: | 04/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | GREENE | ||||||||
| AuthorizedOfficialFirstName: | TODD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8062120244 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 04/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 008529 | TX | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 1653057 | 05 | TX | MEDICAID |