THR/STT SOUTHLAKE ASC LLC NPI 1982716106

NPI Information

NPI: 1982716106
Provider Name: THR/STT SOUTHLAKE ASC, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 45D1071988

Address:
290 MIRON DR
SOUTHLAKE, TX
ZIP 76092
Phone: (817) 442-9300
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THR/STT SOUTHLAKE ASC, LLC is an ambulatory surgical clinic center in Southlake, TX. THR/STT SOUTHLAKE ASC, LLC NPI is 1982716106. The provider is registered as an organization entity type.

The provider's business location address is:

290 MIRON DR
SOUTHLAKE, TX
ZIP 76092-858
Phone: (817) 442-9300
Fax: (817) 416-0108

The provider's authorized official is Mark Hood .
The authorized official title is Ceo and has the following contact phone number (817) 442-9300.

The CLIA number assigned to this NPI record is 45D1071988 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/1/2006 and was last updated on 6/4/2012.

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	00000	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ASC243	MEDICARE ID-TYPE UNSPECIFIED	TEXAS

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

NPI Synchronization or Removal

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