NPIMap

Organization Active NPI

Parkside Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Conroe, TX
National Provider Identifier
1790174274
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PARKSIDE SURGERY CENTER, LLC
Practice address
690 S Loop 336 W
Suite 130
Conroe, TX 77304-3319
Phone
(936) 760-7660
Fax
(936) 760-7661
NPI assigned
Jan 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Nelson Atembe Tajong, M.D.NPI 1760436182
Title
President
Phone
(936) 760-7660

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
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

690 S Loop 336 W
Suite 130
Conroe, TX 77304-3319

Mailing address

690 S Loop 336 W
Suite 130
Conroe, TX 77304-3319
Phone (936) 760-7660

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Parkside Surgery Center LLCCCN 45C0001588
Medicare certification status
ActiveFrom the Provider of Services file

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.

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1790174274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "address_2": "SUITE 130",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-760-7660",
            "fax_number": "936-760-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S LOOP 336 W",
            "address_2": "SUITE 130",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043319",
            "telephone_number": "936-760-7660",
            "fax_number": "936-760-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "TAJONG",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "ATEMBE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-760-7660",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.