MILLER MAC GROUP LLC NPI 1649660168

NPI Information

NPI: 1649660168
Provider Name: MILLER MAC GROUP, LLC

Doing Business As: SOUTHLAKE PAIN AND SURGERY CENTER

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
300 S NOLEN DR STE 160
SOUTHLAKE, TX
ZIP 76092
Phone: (214) 618-5600
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MILLER MAC GROUP, LLC is an ambulatory surgical clinic center in Southlake, TX. MILLER MAC GROUP, LLC NPI is 1649660168. The provider is registered as an organization entity type.
The provider Is Doing Business As Southlake Pain And Surgery Center.

The provider's business location address is:

300 S NOLEN DR STE 160
SOUTHLAKE, TX
ZIP 76092-054
Phone: (214) 618-5600
Fax: (214) 618-7733

The provider's authorized official is Kim Sivaraman .
The authorized official title is Billing Manager and has the following contact phone number (214) 618-5600.

The enumeration date for this NPI number is 2/4/2015 and was last updated on 2/11/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	130212	TEXAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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