Organization Active NPI

Surgical Innovations of Texoma PLLC

  • Surgery Physician
  • Sherman, TX
National Provider Identifier
1205466745
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL INNOVATIONS OF TEXOMA PLLC
Practice address
3305 N Calais Dr Ste 100
Sherman, TX 75090-1796
Phone
(903) 957-0016
Fax
(903) 957-0038
NPI assigned
Jan 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
Michael Chad Friedle, DONPI 1730471749
Title
Owner
Phone
(903) 957-0016

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3305 N Calais Dr Ste 100
Sherman, TX 75090-1796

Mailing address

3305 N Calais Dr Ste 100
Sherman, TX 75090-1796
Phone (903) 957-0016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200423003145 TX Part B Supplier - Clinic/Group Practice 4486084969 Receives reassigned benefits from 1 practitioner
Practice locations: Denison, TX; Sherman, TX

National Provider Directory

National Provider Directory

Locations

5016 Texoma Pkwy
Denison, TX 75020

1000 Pecan Grove Rd E
Sherman, TX 75090

3305 N Calais Dr
Ste 100
Sherman, TX 75090
Phone (903) 548-0011

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJAACD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1205466745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 N CALAIS DR STE 100",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901796",
            "telephone_number": "903-957-0016",
            "fax_number": "903-957-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N CALAIS DR STE 100",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901796",
            "telephone_number": "903-957-0016",
            "fax_number": "903-957-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL INNOVATIONS OF TEXOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "FRIEDLE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-957-0016",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.