Vascular Surgery of Nacogdoches, P.a.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

H6529 Issued in TX

Legal business name

VASCULAR SURGERY OF NACOGDOCHES, P.A.

Practice address

3618 North University Drive
Nacogdoches, TX 75965-2539

Phone

(936) 568-9993

Fax

(936) 568-9996

NPI assigned

Aug 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mark Alford Randel, M.D.

Title

President

Phone

(936) 568-9993

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Vascular Access Center of East Texas Doing business as

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1033423801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630668",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759630668",
            "telephone_number": "936-568-9993",
            "fax_number": "936-568-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 NORTH UNIVERSITY DRIVE",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652539",
            "telephone_number": "936-568-9993",
            "fax_number": "936-568-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VASCULAR SURGERY OF NACOGDOCHES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "RANDEL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALFORD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-568-9993",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "H6529",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "H6529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0016TY",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220035402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220035401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Access Center of East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Utmb Regional Maternal and Child Health Program
• Yuliana Valadez-Maya, RDA
• Roger Ivan Van Horn, DDS
• Vardeman Eye Associates PLLC
• Melanie Montes Vardeman, O.D.
• Xiomara Velazco-Vazquez, MD
• Gerard J Ventura, M.D.
• Hannah Marie Verhalen, M.A., LPC ASSOCIATE
• David Vinther, MD
• Randal N Vinther, M.D.

• Vascular Surgery Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Vascular Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.