Water Leaf Surgery Center Management LLC

NPI #1164942157 in Ft Worth, Texas

Provider Information

NPI Number
1164942157
Entity Type
Organization
Organization Name
Water Leaf Surgery Center Management LLC
Primary Specialty
Electrodiagnostic Medicine
Enumeration Date
Jun 21, 2017
Last Updated
Jun 21, 2017

Practice Location

Address
111 BOLAND ST STE 211
State
Texas
ZIP Code
76107-1265
Phone
(214) 269-3875

Authorized Official

Name
GINA SULLIVAN
Title
BILLING MANAGER
Phone
(214) 269-3875

Specialties & Taxonomy Codes

Specialty
Electrodiagnostic Medicine

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