Organization Active NPI

Advanced Bariatric Surgery Center

Doing business as The Advanced Bariatric Surgery Center

  • Surgery Physician
  • Lubbock, TX
National Provider Identifier
1063588804
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L5583 Issued in TX
Legal business name
ADVANCED BARIATRIC SURGERY CENTER
Doing business as
The Advanced Bariatric Surgery Center
Practice address
3805 22ND PL
Lubbock, TX 79410
Phone
(806) 687-5670
Fax
(806) 687-5673
NPI assigned
Nov 24, 2006
Last updated
Aug 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Dr. David Syn, M.D.NPI 1487730511
Title
President
Phone
(806) 687-5670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L5583 TX Primary

Addresses

Primary practice location

3805 22ND PL
Lubbock, TX 79410

Mailing address

3805 22ND PL
Lubbock, TX 79410-1117
Phone (806) 687-5670

Other identifiers 3

IdentifierTypeStateIssuer
201041925MedicaidNM
159948201MedicaidTX
75136350MedicaidNM

Other names 1

  • The Advanced Bariatric Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051024001070 TX Part B Supplier - Clinic/Group Practice 8527085034 Receives reassigned benefits from 4 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Locations

2424 50th St
Rm 304
Lubbock, TX 79412
Phone (806) 687-5670

3805 22nd Pl
Lubbock, TX 79410
Phone (806) 535-2492

3805 22nd St
Lubbock, TX 79410
Phone (806) 793-0845

Practitioners & affiliated clinicians

Practitioners 7

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1063588804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101117",
            "telephone_number": "806-687-5670",
            "fax_number": "806-687-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-687-5670",
            "fax_number": "806-687-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED BARIATRIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "SYN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-687-5670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L5583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201041925",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159948201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75136350",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Advanced Bariatric Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Advanced Bariatric Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.