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General NPI Number Information
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NPI Number | 1205454006
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Entity Type | Organization
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Legal Business Name | GOLDEN TRIANGLE SURGERY CENTER, LLC
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 01/08/2021
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Provider Practice Location Address
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Address Line | 3560 COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701-4614
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Country | US
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Telephone | 409-835-7070
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Fax | 409-835-6111
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Provider Business Mailing Address
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Address Line | 3560 COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701-4614
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Country | US
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Telephone | 409-835-7070
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. KEVIN TALBOT
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Credential | MD
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Telephone | 409-351-5304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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