Provider Demographics
NPI:1770377947
Name:PSA AMBULATORY SURGICAL CENTER OF NORTH AUSTIN LLC
Entity type:Organization
Organization Name:PSA AMBULATORY SURGICAL CENTER OF NORTH AUSTIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, RCM
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OPALAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-414-9326
Mailing Address - Street 1:2218 SOUTH LAKELINE BLVD
Mailing Address - Street 2:BLDG 1 SUITE 101
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:561-414-9326
Mailing Address - Fax:
Practice Address - Street 1:2218 SOUTH LAKELINE BLVD
Practice Address - Street 2:BLDG 1 SUITE 101
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:561-414-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical