Northeast Methodist Surgicare, LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

000345 Issued in TX

Legal business name

NORTHEAST METHODIST SURGICARE, LTD

Practice address

12702 Ih 35 North
Live Oak, TX 78233-2609

Phone

(210) 575-5700

Fax

(210) 575-5701

NPI assigned

Mar 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Timothy A Carr

Title

Chief Financial Officer

Phone

(210) 575-0238

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Northeast Methodist Ambulatory Surgery Center Doing business as

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568439792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12702 IH 35 NORTH",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332609",
            "telephone_number": "210-575-5700",
            "fax_number": "210-575-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 IH 35 NORTH",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332609",
            "telephone_number": "210-575-5700",
            "fax_number": "210-575-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST METHODIST SURGICARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "210-575-0238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "000345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH1386",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "49000335555",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Methodist Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dung Nguyen, OD
• Huyen Thi Nguyen, M.D.
• Kevin Nguyen, DPT
• Tung Nguyen, M.D.
• Northeast Internal Medicine Associates,PA
• Northeast Orthopaedic & Sports Medicine, LLP
• Northeast Orthopaedics & Sports Medicine
• Northeast Orthopaedics & Sports Medicine, LLP
• Northeast San Antonio Hearing and Balance,LLC
• Northland Hearing Centers, Inc

• Ambulatory Surgical Clinic/Center in Live Oak, TX
• Providers in Live Oak, 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 Aug 22, 2020; 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.