Organization Active NPI

Center for General & Laparoscopic Surgery PA

  • Surgery Physician
  • Sugar Land, TX
National Provider Identifier
1376531905
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L6554 Issued in TX
Legal business name
CENTER FOR GENERAL & LAPAROSCOPIC SURGERY PA
Practice address
138 Eldridge Rd
Suite E
Sugar Land, TX 77478-4083
Phone
(281) 232-3886
Fax
(281) 232-3986
NPI assigned
Oct 7, 2005
Last updated
Jan 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Authorized official

Name
Eseroghene Otah, MDNPI 1477541621
Title
Physician
Phone
(281) 232-3886

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 L6554 TX Primary

Addresses

Primary practice location

138 Eldridge Rd
Suite E
Sugar Land, TX 77478-4083

Mailing address

138 Eldridge Rd
Suite E
Sugar Land, TX 77478-4083
Phone (281) 232-3886

Other identifiers 2

IdentifierTypeStateIssuer
1663841OtherSUFFIX 03 DR E OTAH
1703076OtherCTR FOR GEN AND LAP SURG

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041021000554 TX Part B Supplier - Clinic/Group Practice 2769443902 Receives reassigned benefits from 1 practitioner
Practice locations: Sugar Land, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1376531905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 ELDRIDGE RD",
            "address_2": "SUITE E",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784083",
            "telephone_number": "281-232-3886",
            "fax_number": "281-232-3986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 ELDRIDGE RD",
            "address_2": "SUITE E",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774784083",
            "telephone_number": "281-232-3886",
            "fax_number": "281-232-3986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR GENERAL & LAPAROSCOPIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "OTAH",
        "authorized_official_first_name": "ESEROGHENE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "281-232-3886",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "L6554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUFFIX 03 DR E OTAH",
            "identifier": "1663841",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTR FOR GEN AND LAP SURG",
            "identifier": "1703076",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.