Lake Travis Surgical Associates PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKE TRAVIS SURGICAL ASSOCIATES PA

Practice address

9300 Kirby Drive
Suite 100
Houston, TX 77054

Phone

(832) 201-5157

Fax

(832) 201-5167

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Jodie R Ellis, CPC-H

Title

Business Office Manager

Phone

(832) 201-5157

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229990400000",
    "number": "1942483128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1759",
            "address_2": "DEPT 765",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772511759",
            "telephone_number": "832-201-5157",
            "fax_number": "832-201-5167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 KIRBY DRIVE",
            "address_2": "SUITE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77054",
            "telephone_number": "832-201-5157",
            "fax_number": "832-201-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE TRAVIS SURGICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2008-12-23",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "832-201-5157",
        "authorized_official_credential": "CPC-H"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Lajeunesse, DPT
• Lajja Neurology Association
• Lajorca International LLC
• Lakay Multi Services, LLC
• Lake Breeze Surgical Affiliates, PA
• Jordan Elizabeth Lake, M.D.
• Kamryn Lake
• Lloyd E Lake Jr., DDS
• Yasmin Natasha Lake, MD
• Lakefront Care, Inc

• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, 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 Dec 23, 2008; 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.