Provider Demographics
NPI:1174069355
Name:PARKWAY SURGICENTER LLC
Entity type:Organization
Organization Name:PARKWAY SURGICENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-262-0300
Mailing Address - Street 1:3301 SPRING STUEBNER RD
Mailing Address - Street 2:100
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5194
Mailing Address - Country:US
Mailing Address - Phone:346-262-0300
Mailing Address - Fax:
Practice Address - Street 1:3301 SPRING STUEBNER RD
Practice Address - Street 2:100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-5194
Practice Address - Country:US
Practice Address - Phone:346-262-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical