VASCULAR SURGERY OF NACOGDOCHES, P.A.


Address: 3618 North University Drive, Nacogdoches, TX 75965-2539
Phone: 9365689993

VASCULAR SURGERY OF NACOGDOCHES, P.A. (NPI# 1033423801) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033423801
Entity Type Organization
Organization Name VASCULAR SURGERY OF NACOGDOCHES, P.A.
Other Organization Name VASCULAR ACCESS CENTER OF EAST TEXAS
Practice Address 3618 North University Drive
Nacogdoches
TX 75965-2539
Mailing Address Po Box 630668
Nacogdoches
TX 75963-0668
Practice Telephone 9365689993
Practice Fax Number 9365689996
Mailing Telephone 9365689993
Mailing Fax Number 9365689996
Enumeration Date 2010-08-03
Last Update Date 2011-09-28
Authorized Official Name DR. MARK ALFORD RANDEL (PRESIDENT)
Authorized Official Telephone 9365689993
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208600000X Surgery H6529 TX Allopathic & Osteopathic Physicians
Y 2086S0129X Surgery
Specialization: Vascular Surgery
H6529 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX 220035402 05
TX BLUE CROSS BLUE SHIELD 0016TY 01
TX 220035401 05

Other Provider/Organization Names

Other Name Type Code
Vascular Access Center of East Texas Doing Business As Name - Organization

Office Location

Street Address 3618 NORTH UNIVERSITY DRIVE
City NACOGDOCHES
State TX
Zip Code 75965-2539

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1649839135 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 2019-06-10
1518520493 Billy Jobe Pharmacist 917 East Austin, Nacogdoches, TX 75965 2019-04-17
1295217610 Sarah Ponder Registered Nurse 625 Woodway Lane, Nacogdoches, TX 75965 2018-09-01
1083107684 Aakash Deep Gupta Dentist 4610 North St Ste 101b, Nacogdoches, TX 75965 2018-06-08
1679097455 Emily Morris Taravella Counselor 3524 Ne Stallings Drive, Nacogdoches, TX 75965 2017-08-02
1457809949 Kassey Osborn Nurse Practitioner 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 2016-09-14
1629426747 Lisa Greathouse Technician, Other 500 Chincapin, Westville, OK 75965 2016-05-31
1457741704 Nuch of Texas Pediatrics 1305 North Street, Nacogdoches, TX 75965 2015-01-26
1730506031 Benjamin Patrick Thompson Obstetrics & Gynecology 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 2014-03-25
1255761813 Kallie Krawietz Counselor 2214 N Pecan Street, Nacogdoches, TX 75965 2013-11-19
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Taxonomy Information

Taxonomy Code 2086S0129X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Vascular Surgery

Taxonomy Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1407482003 Endovascular Lab Pllc Surgery 612 N Washington Avenue, Suite 100, Odessa, TX 79761 2020-03-16
1356980163 Jeffrey M. Martinez, M.d., P.a. Surgery 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 2019-12-26
1245875061 Usa Vascular Center of Dallas Pllc Surgery 2300 W Fm 544 Ste B, Wylie, TX 75098-4931 2019-11-15
1740830959 Coastal Plains Endeavors LLC Surgery 1602 E Houston St Ste A, Beeville, TX 78102-5335 2019-09-19
1205488632 Usa Vein Clinics of Dallas Pllc Surgery 3128 Forest Ln Ste 320, Dallas, TX 75234-7761 2019-07-16
1558922625 Sudad Kareem Al Hadad Surgery 12579 Richmond Ave Ste 800, Houston, TX 77082-2555 2019-06-27
1043782907 Timothy C. Pringle Md Pa Surgery 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 2018-12-17
1518449701 Kenton Lee Rommens Surgery 6400 Fannin St. Suite 2850, Houston, TX 77030 2018-09-04
1336633999 Total Vein Treatment Centers Surgery 2301 Marsh Ln Ste 210, Plano, TX 75093-8497 2018-06-18
1508384652 Jcm Vein Pllc Vein Care Coastal Bend Surgery 3301 S Alameda St Ste 402, Corpus Christi, TX 78411-1882 2017-09-08
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Competitor

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City NACOGDOCHES
Zip Code 75965

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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