Organization Active NPI

Athens Surgical Assoc., P a

  • Surgery Physician
  • Athens, TX
National Provider Identifier
1487787198
Registry record updated Aug 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ATHENS SURGICAL ASSOC., P A
Practice address
115 Medical Cir
Suite 107
Athens, TX 75751-9003
Phone
(903) 675-5781
Fax
(903) 677-1008
NPI assigned
Mar 13, 2007
Last updated
Aug 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2012

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

Authorized official

Name
Mrs. Donna M Pugh
Title
Administrator
Phone
(903) 675-5781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

115 Medical Cir
Suite 107
Athens, TX 75751-9003

Mailing address

PO Box C
Athens, TX 75751-1078
Phone (903) 675-5781

Other identifiers 2

IdentifierTypeStateIssuer
00N482OtherTXBCBS
084202301MedicaidTX

National Provider Directory

National Provider Directory

Locations

500 Richardson St
Athens, TX 75751
Phone (903) 675-5781

Practitioners & affiliated clinicians

Practitioners 3

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1487787198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757511078",
            "telephone_number": "903-675-5781",
            "fax_number": "903-677-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MEDICAL CIR",
            "address_2": "SUITE 107",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519003",
            "telephone_number": "903-675-5781",
            "fax_number": "903-677-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS SURGICAL ASSOC., P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-675-5781",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00N482",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084202301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.