EAST TEXAS FIRST SURGICAL SUPPORT PLLC (NPI# 1568009058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568009058 |
| Entity Type | Organization |
| Organization Name | EAST TEXAS FIRST SURGICAL SUPPORT PLLC |
| Practice Address |
3414 Golden Rd Tyler TX 75701-8336 |
| Mailing Address |
Po Box 9879 Spring TX 77387-6879 |
| Practice Telephone | 8007858765 |
| Mailing Telephone | 8007858765 |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2020-02-20 |
| Authorized Official Name | KEN KAMINSKI (MANAGER) |
| Authorized Official Telephone | 9039397792 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
3414 GOLDEN RD |
| City | TYLER |
| State | TX |
| Zip Code | 75701-8336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487640173 | James Robert Harris | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2005-09-27 |
| 1104433739 | Ortholonestar, Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-09-28 |
| 1912528498 | Brooke Nicole Mcdaniel | Occupational Therapy Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-05-06 |
| 1912526153 | Iana G Harris | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-04-08 |
| 1104450832 | Lindsey Michelle Markel | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2020-03-03 |
| 1770144701 | Olsv3 Pllc | Orthopaedic Surgery | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-20 |
| 1740840651 | Samantha Anderson Ray | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2019-06-13 |
| 1326540097 | Jennifer Marie Mckelva | Physician Assistant | 3414 Golden Rd, Tyler, TX 75701-8336 | 2018-03-08 |
| 1730601790 | Justin Alan Williams | Nurse Practitioner | 3414 Golden Rd, Tyler, TX 75701-8336 | 2017-07-12 |
| 1114466638 | Kristopher Neely | Physical Therapist | 3414 Golden Rd, Tyler, TX 75701-8336 | 2017-02-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
| 1487098240 | Charles Joseph Keith Jr. | Surgery | 1100 E Lake St Ste 150, Tyler, TX 75701-3357 | 2013-04-24 |
| 1922298876 | Stefan P. Thiele, M.d., P.a. | Surgery | 1320 Doctors Dr, Tyler, TX 75701-2262 | 2007-07-26 |
| 1568515393 | Vivek Patel | Surgery | 700 Olympic Plaza Cir Ste 580, Tyler, TX 75701-1951 | 2007-01-18 |
| 1801901376 | Harris Roberts Fender Jr. | Surgery | 1015 Hospital Drive, Tyler, TX 75701 | 2006-08-21 |
| 1104890961 | Robert A Mckinney Jr. | Surgery | 910 E Houston, Ste 550, Tyler, TX 75701 | 2006-02-16 |
| 1083686877 | Margarita De La Garza-grahm | Surgery | 1020 E Lake St, Tyler, TX 75701-2033 | 2006-02-06 |
| 1043206774 | Hugh P Babineau | Surgery | 1100 E Lake St, Ste 230, Tyler, TX 75701-3343 | 2005-09-27 |
| 1891797429 | Mark Richard Robbins | Surgery | 1040 S Fleishel Ave, Tyler, TX 75701-2031 | 2005-08-12 |
| 1750383386 | East Texas Vascular Associates, P.a. | Surgery | 700 Olympic Plaza Cir Ste 510, Tyler, TX 75701-1952 | 2005-08-12 |
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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.