Organization Active NPI

TSC Surgical Group PLLC

  • Surgical Oncology Physician
  • Richardson, TX
National Provider Identifier
1013264118
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
K3263 Issued in TX
Legal business name
TSC SURGICAL GROUP PLLC
Practice address
2805 E President George Bush Hwy
Richardson, TX 75082-3561
Phone
(972) 619-3500
NPI assigned
Aug 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Authorized official

Name
Dhiresh Rohan Jeyarajah, MD
Title
Owner/Physician
Phone
(972) 619-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086X0206X K3263 TX Primary

Addresses

Primary practice location

2805 E President George Bush Hwy
Richardson, TX 75082-3561

Mailing address

PO Box 674096
Dallas, TX 75267-4096
Phone (972) 619-3500

Other identifiers 1

IdentifierTypeStateIssuer
310761701MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512086400000",
    "number": "1013264118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674096",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752674096",
            "telephone_number": "972-619-3500",
            "fax_number": "214-272-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 E PRESIDENT GEORGE BUSH HWY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750823561",
            "telephone_number": "972-619-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TSC SURGICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2017-12-01",
        "status": "A",
        "authorized_official_last_name": "JEYARAJAH",
        "authorized_official_first_name": "DHIRESH",
        "authorized_official_middle_name": "ROHAN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "972-619-3500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "K3263",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310761701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2017; 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.