Organization Name: | CENTRAL TEXAS ENDOSCOPY CENTER LLC |
NPI Number: | 1003887225 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PHILLIP A CLENDENIN (PRESIDENT) |
Mailing Address: | 2206 E. Villa Maria Bryan |
State: | TX US |
Postal Code: | 778022547 |
Phone Number: | 9797744211 |
Fax Number: | 9797742822 |
NPI Enumeration Date: | 01/27/2006 |
NPI Last Update Date: | 02/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |