Basic Information
| Provider Information | |||||||||
| NPI: | 1679200885 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMIT BARIATRIC AND ROBOTIC SURGICAL SPECIALISTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 LBJ FWY STE 800 | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752434310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9727925700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 S MAIN ST STE 111 | ||||||||
| Address2: | |||||||||
| City: | BOERNE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780062838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302238150 | ||||||||
| FaxNumber: | 8302238151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2022 | ||||||||
| LastUpdateDate: | 11/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | FARRER | ||||||||
| AuthorizedOfficialFirstName: | REX | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8017556559 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 11/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.