Provider Demographics
NPI:1902099575
Name:ARLINGTON MANSFIELD SURGERY-ENDOSCOPY CENTER, LLC
Entity Type:Organization
Organization Name:ARLINGTON MANSFIELD SURGERY-ENDOSCOPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-966-1579
Mailing Address - Street 1:701 INTERSTATE 20 E
Mailing Address - Street 2:SUITE 151
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1130
Mailing Address - Country:US
Mailing Address - Phone:817-966-1579
Mailing Address - Fax:
Practice Address - Street 1:701 INTERSTATE 20 E
Practice Address - Street 2:SUITE 151
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1130
Practice Address - Country:US
Practice Address - Phone:817-966-1579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy