Gulfstream Surgical Fort Worth LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GULFSTREAM SURGICAL FORT WORTH LLC

Practice address

975 Haskell St
Fort Worth, TX 76107-2653

Phone

(214) 695-6273

NPI assigned

Oct 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Daniel D'Amico

Title

Manager

Phone

(214) 695-6273

Specialties & licenses 1

Addresses

Listed as

Gulfstream Surgical Fort Worth LLCCCN 45C0001724

Medicare certification status

Terminated Voluntary: merger or closure, Sep 3, 2024From the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Lewis 360 Medical Solutions PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
  • NPI 1932509635

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1144827114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 HASKELL ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072653",
            "telephone_number": "214-695-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 HASKELL ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072653",
            "telephone_number": "214-695-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFSTREAM SURGICAL FORT WORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "D'AMICO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-695-6273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Guinn, RN
• Meena Ezzat Guirguis, M.D.
• Ricardo Guirola, M.D.
• Edward Gula, CNIM
• Whitney Gulde, PA
• Deven Emmanuel Gulick, MD
• Hayleyesus Paulos Gulilat, MSN, RN, FNP-C
• Dominick Anthony Gulizo III
• Catherine Gulley, LCDC
• Taylor Cemone Gulley, DO

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.