| Organization Name: | SELECT AMBULATORY SURGERY CENTER OF FT WORTH LLC |
| NPI Number: | 1033589742 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTY MCGILL (DIRECTOR OF NETWORK DEVELOPMENT) |
| Mailing Address: | 2001 Cooper St Ft Worth |
| State: | TX US |
| Postal Code: | 761042529 |
| Phone Number: | 8173340990 |
| Fax Number: | |
| NPI Enumeration Date: | 10/07/2015 |
| NPI Last Update Date: | 01/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |