Southside Specialty Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHSIDE SPECIALTY SURGICAL CENTER LLC

Practice address

6005 Holly Rd
Corpus Christi, TX 78412

Phone

(361) 548-3334

NPI assigned

Feb 2, 2018

Last updated

Jul 24, 2019By 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

Gabriel Lopez, MDNPI 1801814165

Title

Physician

Phone

(361) 225-0089

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Southside Specialty Surgical Center LLCCCN 45C0001701

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Antonio Bogdan Fratila, M.D.

  • Anesthesiology Physician
  • Corpus Christi, TX
  • NPI 1467484691
  Medicare reassignment NPD
• Gabriel Lopez, M.D.

  • Interventional Pain Medicine Physician
  • Corpus Christi, TX
  • NPI 1801814165
  NPD Authorized official

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1881193183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 BROADMOOR DR",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784132714",
            "telephone_number": "361-548-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 HOLLY RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78412",
            "telephone_number": "361-548-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE SPECIALTY SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "361-225-0089",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Texas Surgical Assisting LLC
• South TX Mission of Mercy (Compassionate Clinic)
• Southside Family Care Associates PA
• Southside Pharmacy Inc (Nichols Southside Pharmacy)
• Southside Pharmacy Inc
• Southside Women's Center, P.a.
• Southwest LTC - Corpus, LLC (Harbor View Care Center)
• Kathryn W Soward, PHD, LPC
• Noe Soza, M.D.
• Spark Rehab Specialist LLC

• Ambulatory Surgical Clinic/Center in Corpus Christi, TX
• Providers in Corpus Christi, 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 Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.