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).
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 |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 220035402 | 05 | |
TX | BLUE CROSS BLUE SHIELD | 0016TY | 01 |
TX | 220035401 | 05 |
Other Name | Type Code |
---|---|
Vascular Access Center of East Texas | Doing Business As Name - Organization |
Street Address |
3618 NORTH UNIVERSITY DRIVE |
City | NACOGDOCHES |
State | TX |
Zip Code | 75965-2539 |
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 |
Find all providers in zip 75965 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
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. |
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 |
Find all providers with the same taxonomy |
City | NACOGDOCHES |
Zip Code | 75965 |
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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.