South Side Surgery PA

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

SOUTH SIDE SURGERY PA

Practice address

3060 Communications Pkwy
St 104
Plano, TX 75093-8449

Phone

(214) 317-4666

Fax

(214) 317-4667

NPI assigned

Jul 2, 2008

Last updated

Jul 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan McCormick, MD

Title

Ceo

Phone

(214) 317-4666

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1841452653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678716",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678716",
            "telephone_number": "214-317-4666",
            "fax_number": "214-317-4667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 COMMUNICATIONS PKWY",
            "address_2": "ST 104",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938449",
            "telephone_number": "214-317-4666",
            "fax_number": "214-317-4667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SIDE SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-317-4666",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Source One Physical Therapy
• Source One Rehabilitation
• Source One Rehabilitation
• Source One Therapy, LLC
• South Limestone Hospital District (Accel at Willow Bend)
• South Texas Dental Associates, L.P.
• South Texas Progressive Radiology, PLLC
• Southern Butterfly Productions (Frisco Therapy Solutions)
• Southern Diagnositcs LLC
• Southern Endocrinology (Elite Endocrinology & Diabetes Associates)

• Pain Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Pain Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.