NPIMap

Organization Active NPI

Vascular Surgery of Nacogdoches, P.a.

Doing business as Vascular Access Center of East Texas

  • Vascular Surgery Physician
  • Nacogdoches, TX
National Provider Identifier
1033423801
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
H6529 Issued in TX
Legal business name
VASCULAR SURGERY OF NACOGDOCHES, P.A.
Doing business as
Vascular Access Center of East Texas
Practice address
3618 North University Drive
Nacogdoches, TX 75965-2539
Phone
(936) 568-9993
Fax
(936) 568-9996
NPI assigned
Aug 3, 2010
Last updated
Sep 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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.NPI 1629103619
Title
President
Phone
(936) 568-9993

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X H6529 TX
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X H6529 TX Primary

Addresses

Primary practice location

3618 North University Drive
Nacogdoches, TX 75965-2539

Mailing address

PO Box 630668
Nacogdoches, TX 75963-0668
Phone (936) 568-9993

Other names 1

  • Vascular Access Center of East Texas Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vascular Access Center of East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • 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.