SOUTHWEST VASCULAR AND SURGICAL GROUP
Osteopathic Medicine at Forest Ln, Dallas, TX

License number
Texas E6012
Category
Radiology
Type
Surgery
License number
Texas K9914
Category
Radiology
Type
Surgery
License number
Texas J3706
Category
Radiology
Type
Surgery
License number
Texas J0020
Category
Radiology
Type
Surgery
License number
Texas L3839
Category
Radiology
Type
Vascular Surgery
License number
Texas H2239
Category
Radiology
Type
Surgical Oncology
License number
Texas E3311
Category
Osteopathic Medicine
Type
Colon & Rectal Surgery
License number
Texas K7546
Category
Osteopathic Medicine
Type
Colon & Rectal Surgery
Owner
Name: MRS. TANYA S. GREEN
Title: PRACTICE MANAGER
Phone: (972) 566-8039
Address
Address
7777 Forest Ln SUITE C-760, Dallas, TX 75230
National Provider ID: 1639236425
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHWEST VASCULAR AND SURGICAL GROUP PA

Dallas, TX

Status:
Inactive
Doing business as:
Dallas Surgical Associates<br>Dallas Surgical Group<br>Southwest Vascular and Surgical Group PA
Registration:
Apr 5, 1993
Addresses:
7777 Frst Ln #760, Dallas, TX 75230 (Mailing)
221 W Colorado Blvd, Dallas, TX 75208
State ID:
0081431303
Business type:
Professional Association
Director , Members:
Peter D. Beitsch President, Director , Member, inactive,Kevin W. Niblett Treasurer , Director , Member , Secretary, inactive,Walton A. Taylor Director , Member, inactive,...
Agent:
Peter D Beitsch,7777 Frst Ln, Dallas, TX 75230 (Physical)
TIN:
17524744004

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