Lakeshore Surgical LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

LAKESHORE SURGICAL LLC

Practice address

1207 N Houston Ave
Humble, TX 77338-2591

Phone

(832) 916-2422

Fax

(832) 916-2522

NPI assigned

Apr 11, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Angela Michelle Lewis-Traylor, MD

Title

Ceo

Phone

(832) 916-2422

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dixie Melillo, M.D.

  • Diagnostic Radiology Physician
  • Pasadena, TX
  • NPI 1407857832

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1801329321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 N HOUSTON AVE",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773382591",
            "telephone_number": "832-916-2422",
            "fax_number": "832-916-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 N HOUSTON AVE",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773382591",
            "telephone_number": "832-916-2422",
            "fax_number": "832-916-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "LEWIS-TRAYLOR",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-916-2422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370843001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Humble",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Humble",
            "address_1": "1207 N Houston Ave",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773382591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Humble",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Humble",
            "address_1": "1207 N Houston Ave",
            "city": "Humble",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773382591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lake Houston Asthma Allergy Immunology
• Lake Houston Counseling Center
• Lake Houston Interventional Pain PLLC
• Lake Houston Physical Therapy Limited Partnership
• Lake Houston Wellness Center LLC
• Amy G Lamarca Lyon, MSW, LCSW-S
• Myrtle Joyce Lambie, CRNA
• Lan K Nguyen, MD, PA
• Tierney Sinead Lancaster, LCSW
• Lander Holistic Health and Wellness

• Surgery Physician in Humble, TX
• Providers in Humble, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.