Dehaven Cataract Surgical Center ,Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

000228 Issued in TX

Legal business name

DEHAVEN CATARACT SURGICAL CENTER ,INC

Doing business as

Dehaven Surgical Center, Inc

Practice address

1424 East Front
Tyler, TX 75702-8501

Phone

(903) 595-7510

Fax

(903) 526-5491

NPI assigned

Jul 7, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Gina V. Lowndes

Title

Financial Service Manager

Phone

(903) 595-7510

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Dehaven Surgical Center, Inc Doing business as

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1376540096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130639",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757130639",
            "telephone_number": "903-595-7510",
            "fax_number": "903-526-5491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 EAST FRONT",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028501",
            "telephone_number": "903-595-7510",
            "fax_number": "903-526-5491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEHAVEN CATARACT SURGICAL CENTER ,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "LOWNDES",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "FINANCIAL SERVICE MANAGER",
        "authorized_official_telephone_number": "903-595-7510",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "000228",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "000228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085855701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH1281",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7170358",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dehaven Surgical Center, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lee Ann Decker, LCDC
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• Assefa Degu
• Dehaven Eye Clinic PA
• Dehaven Eye Clinic PA
• Thomas J. Dehaven, M.D.
• Deity Health Care LLC
• John Dejesus

• Ambulatory Surgical Clinic/Center in Tyler, TX
• Providers in Tyler, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; 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.