Provider Demographics
NPI:1053714758
Name:TEXAS PRECISION SURGERY CENTER
Entity type:Organization
Organization Name:TEXAS PRECISION SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKET PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:FINKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-344-8737
Mailing Address - Street 1:6209 LAGO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6343
Mailing Address - Country:US
Mailing Address - Phone:757-344-8737
Mailing Address - Fax:
Practice Address - Street 1:5721 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4138
Practice Address - Country:US
Practice Address - Phone:361-334-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351254301Medicaid