Northeast Texas Surgical Center
LBN: Northeast Texas Surgery Center
Northeast Texas Surgical Center is an health care organization with primary practice located at 1902 Moores Ln Suite B, Texarkana TX 75503-4610. The organization recently has only one registered license in Ambulatory Health Care Facilities / Ambulatory Surgical, which is considered as the primary health care specialty.
Northeast Texas Surgery Center can be contacted via phone (903) 792-2108, or through Burnham, Penny Jo via phone (903) 792-2108.
Contact Information
Primary practice address
1902 Moores Ln Suite B
Texarkana TX 75503-4610
Phone: (903) 792-2108
Fax: (903) 792-0606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 008109 | Texas |
| Ambulatory Health Care Facilities / Ambulatory Surgical | 261QA1903X | 008678 | Texas |
Profile Details
| NPI number | 1063498657 |
|---|---|
| LBN Legal business name | Northeast Texas Surgery Center |
| DBA Doing business as | Northeast Texas Surgical Center |
| Authorized official | Burnham, Penny Jo Registered Nurse (RN) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Aug 12th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063498657 | NPPES |
| Arkansas | Other | 10517 | AR BCBS |
| Arkansas | Other | HH1366 | AR BCBS |
| Arkansas | MEDICAID | 126632128 | AR BCBS |
| Arkansas | MEDICAID | 176285801 | AR BCBS |
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