Provider Demographics
NPI:1023341740
Name:OPHTHALMOLOGY SURGERY CENTER OF DALLAS, LLC
Entity type:Organization
Organization Name:OPHTHALMOLOGY SURGERY CENTER OF DALLAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INGER
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-750-9288
Mailing Address - Street 1:10740 N CENTRAL EXPY STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2162
Mailing Address - Country:US
Mailing Address - Phone:214-750-9288
Mailing Address - Fax:214-750-9268
Practice Address - Street 1:10740 N CENTRAL EXPY
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2104
Practice Address - Country:US
Practice Address - Phone:214-360-0000
Practice Address - Fax:214-360-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical