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NPI Code Detail

MEDICARE: UROLOGY SURGERY CENTER OF TEXARKANA

MEDICARE: UROLOGY SURGERY CENTER OF TEXARKANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center008308TX

General Provider Information

NPI Number : 1972562940
Entity Type Code : Organization
Provider Name (Legal Business Name) : UROLOGY SURGERY CENTER OF TEXARKANA
Provider Business Mailing Address
First Line : 1902 MOORES LN
Second Line : SECOND FLOOR
City : TEXARKANA
State : TX
Zip : 75503-4610
Country : US
Telephone Number : 903-792-7515
Fax Number : 903-793-8225
Provider Business Practice Location Address
First Line : 1902 MOORES LN
Second Line : SECOND FLOOR
City : TEXARKANA
State : TX
Zip : 75503-4610
Country : US
Telephone Number : 903-792-7515
Fax Number : 903-793-8225
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. VONGPHANET JOE SIHARATH
Credential : M.B.A.
Telephone Number : 903-792-7515
Provider Enumeration Date : 03/20/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1558363507 — DR. CHRISTOPHER TODD PAYNE MD
Practice Location Address:
1902 MOORES LN
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-7515
Practice Fax: 903-791-8645
1144222100 — DR. GLEN A ROUNTREE MD
Practice Location Address:
1902 MOORES LN
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-7515
Practice Fax: 903-791-8645
1730183534 — DR. CORDELL L KLEIN MD
Practice Location Address:
1902 MOORES LN
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-7515
Practice Fax: 903-791-8645
1538163910 — DR. JASON T PICKELMAN MD
Practice Location Address:
1902 MOORES LN
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-7515
Practice Fax: 903-791-8645
1700868528 — COLLOM & CARNEY CLINIC ASSOCIATION
Practice Location Address:
1902 MOORES LN
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-7515
Practice Fax:
1063498657 — NORTHEAST TEXAS SURGERY CENTER
Practice Location Address:
1902 MOORES LN , SUITE B
TEXARKANA, TX
75503-4610
Practice Phone: 903-792-2108
Practice Fax: 903-792-0606

Directions to “UROLOGY SURGERY CENTER OF TEXARKANA ” Practice Location

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