Bayshore Surgery Center, LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007306 Issued in TX

Legal business name

BAYSHORE SURGERY CENTER, LTD

Doing business as

Bayshore Surgery Center

Practice address

3333 Bayshore Blvd
Pasadena, TX 77504-1952

Phone

(832) 386-0320

Fax

(832) 386-0240

NPI assigned

Apr 7, 2006

Last updated

Oct 22, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Don Liedtke

Title

Vice President

Phone

(615) 344-5507

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bayshore Surgery Center Doing business as

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1508829011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BAYSHORE BLVD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041952",
            "telephone_number": "832-386-0320",
            "fax_number": "832-386-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BAYSHORE BLVD",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041952",
            "telephone_number": "832-386-0320",
            "fax_number": "832-386-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSHORE SURGERY CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "LIEDTKE",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-344-5507"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144393901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bayshore Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bayshore Health Mart, Inc. (Bayshore Health Mart)
• Bayshore Optical Company
• Bayshore Pediatrics
• Bayshore Pharmacy Inc (Bayshore Pharmacy)
• Bayshore Radiation Oncology Services, PLLC
• Bayside a S C LP (Bayside Surgery Center)
• Marvin L Baza Jr., O.D.
• Chloe Beadnell, DC
• Michael Dewain Beck, DDS
• Allison Joanna Beckford, M.A., CCC-SLP

• Ambulatory Surgical Clinic/Center in Pasadena, TX
• Providers in Pasadena, 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 Oct 22, 2007; 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.