Provider Demographics
NPI:1518841071
Name:PARKSIDE GI SURGICENTER, LLC
Entity type:Organization
Organization Name:PARKSIDE GI SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-789-2816
Mailing Address - Street 1:690 S LOOP 336 W STE 130
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3330
Mailing Address - Country:US
Mailing Address - Phone:936-760-7660
Mailing Address - Fax:
Practice Address - Street 1:690 S LOOP 336 W STE 130
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3330
Practice Address - Country:US
Practice Address - Phone:936-760-7660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical