NPIMap

Organization Active NPI

Texarkana Surgical First Assistant PLLC

  • Surgical Technologist
  • Texarkana, TX
National Provider Identifier
1831211317
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
License
SA00281 Issued in TX
Legal business name
TEXARKANA SURGICAL FIRST ASSISTANT PLLC
Practice address
2600 Saint Michael Dr
Texarkana, TX 75503-2372
Phone
(903) 614-1000
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Ms. Wendy Gordon, LSA
Title
Lsa
Phone
(817) 294-7444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZS0410X SA00281 TX Primary

Addresses

Primary practice location

2600 Saint Michael Dr
Texarkana, TX 75503-2372

Mailing address

PO Box 11219
Fort Worth, TX 76110-0219
Phone (817) 294-7444

Other identifiers 2

IdentifierTypeStateIssuer
0055FLOtherTXBCBSTX
SA00281OtherTXLICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1831211317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11219",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761100219",
            "telephone_number": "817-294-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SAINT MICHAEL DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032372",
            "telephone_number": "903-614-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA SURGICAL FIRST ASSISTANT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "LSA",
        "authorized_official_telephone_number": "817-294-7444",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSA"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "0055FL",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "SA00281",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.