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General NPI Number Information
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NPI Number | 1306989249
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS SURGERY CENTER LLC
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 3302 NE STALLINGS DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-8727
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Country | US
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Telephone | 936-564-3600
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Fax | 936-564-3770
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Provider Business Mailing Address
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Address Line | 3302 NE STALLINGS DR
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City | NACOGDOCHES
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State | TX
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Zip | 75965-8727
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Country | US
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Telephone | 936-564-3600
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Fax | 936-564-3770
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Authorized Official
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Title or Position | MD
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Name | DR. SHANNON L SMITH
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Credential | MD
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Telephone | 936-564-3600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 008491
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License Number State | TX
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