LAKESIDE SURGERY PA (NPI# 1831468800) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831468800 |
| Entity Type | Organization |
| Organization Name | LAKESIDE SURGERY PA |
| Practice Address |
4450 Tubbs Rd Rockwall TX 75032-6308 |
| Practice Telephone | 9727723290 |
| Practice Fax Number | 9727223815 |
| Mailing Telephone | 9727223290 |
| Mailing Fax Number | 9727223815 |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | TERRI R PHILLIP (PRACTICE MANAGER) |
| Authorized Official Telephone | 9727223290 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | J2983 | TX | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | P6593 | TX | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | K6483 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TX LICENSE | K6483 | 01 |
| TX | NPI # | 1326097676 | 01 |
| TX | TX LICENSE | J2983 | 01 |
| TX | STATE LICENSE | P6593 | 01 |
| TX | NPI # | 1952393415 | 01 |
| Street Address |
4450 TUBBS RD |
| City | ROCKWALL |
| State | TX |
| Zip Code | 75032-6308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952393415 | Katherine R Makohon | Specialist | 4450 Tubbs Rd, Rockwall, TX 75032-6308 | 2005-08-19 |
| 1952577546 | Caraleigh Nicole Buxie | Specialist | 4450 Tubbs Rd, Rockwall, TX 75032-6308 | 2008-05-02 |
| 1326097676 | Jeffrey S Stephens | Specialist | 4450 Tubbs Rd, Rockwall, TX 75032-6308 | 2006-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780291229 | Alexandra Messer | Nurse Practitioner | 6435 S Farm To Market, #201, Heath, TX 75032 | 2020-09-29 |
| 1720649338 | Randalls Food & Drugs Lp | Durable Medical Equipment & Medical Supplies | 551 Laurence Dr, Health, TX 75032 | 2019-06-25 |
| 1346725579 | Arc 32 Family Dentistry | Dentist | 4 Horizon Court Suite 400, Heath, TX 75032 | 2018-10-03 |
| 1275039257 | Karina Bartz Dds Pllc | Dentist | 110 Smirl Drive, Suite 101, Heath, TX 75032 | 2018-03-30 |
| 1861994337 | Lumin Health Physician Group, Pa | Pain Medicine | 4450 Tubbs Road, Rockwall, TX 75032 | 2018-03-01 |
| 1871002816 | Aurentz Family Dental | Clinic/Center | 3140 Horizon Rd Suite 103, Rockwall, TX 75032 | 2017-09-21 |
| 1902200199 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 4282 Ridge Rd, Heath, TX 75032 | 2014-10-16 |
| 1962744714 | Yongrui Luan | Pediatrics | 1005 W Ralph Hall Pkwy Ste 135, Rockwall, TX 75032 | 2013-03-20 |
| 1558608679 | Nikalaus Loyd Laymon | Massage Therapist | 860 Ralph Hall Pkwy, #46, Rockwall, TX 75032 | 2013-01-09 |
| 1932444999 | Chiro One Wellness Center of Rockwall Pllc | Chiropractor | 2881 Market Center Drive, Rockwall, TX 75032 | 2012-12-03 |
| Find all providers in zip 75032 | ||||
| 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 |
|---|---|---|---|---|
| 1972110971 | Metroplex Surgical Institute Pllc | Surgery | 2937 Lago Vista Ln, Rockwall, TX 75032-5466 | 2020-09-24 |
| 1124360045 | Ra Surgical Group | Surgery | 3290 Bastrop Ct, Rockwall, TX 75032-4407 | 2013-03-18 |
| 1487858304 | Amy Brazda Eastman | Surgery | 3142 Horizon Rd Ste 110, Rockwall, TX 75032-7810 | 2007-06-13 |
| 1508897810 | Colleen I Kennedy | Surgery | 1309 Ridge Rd, Suite 109, Rockwall, TX 75087-4206 | 2006-07-05 |
| 1295062172 | David W. Ritter, M.d., P.a. | Surgery | 6800 Heritage Pkwy, Suite 200, Rockwall, TX 75087-8746 | 2009-11-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881209708 | Preva Surgical Partners Cypress LLC | Surgery | 13114 Fm 1960 Rd W Ste 118, Houston, TX 77065-5590 | 2020-09-09 |
| 1063021749 | Brooke Nicole Harris | Surgery | 355 E Vista Ridge Mall Dr Apt 4933, Lewisville, TX 75067-4024 | 2020-07-28 |
| 1609484872 | Deepak Dev Vivekanandan | Surgery | 7703 Floyd Curl Dr # Mc-7742, San Antonio, TX 78229-3901 | 2020-07-14 |
| 1760009195 | Tomball Surgical Assistant Service LLC | Surgery | 18220 Tomball Pkwy # 249, Houston, TX 77070-4347 | 2020-07-01 |
| 1174147086 | North Texas General Surgery Pllc | Surgery | 1600 Coit Rd Ste 207, Plano, TX 75075-6172 | 2020-06-05 |
| 1619591690 | Expert Surgical, Pllc | Surgery | 3537 S I 35 E Ste 200, Denton, TX 76210-6814 | 2020-06-04 |
| 1831712314 | Merten Gene Pearson | Surgery | 7306 Sw 34th Ave Ste 6, Amarillo, TX 79121-1446 | 2020-05-19 |
| 1558983098 | Aleshia Yvette Toler-levi | Surgery | 405 Schley Ave, Orange, TX 77630-3503 | 2020-05-06 |
| 1508487570 | Somkenechi Ijeoma Ajene | Surgery | 301 University Boulevard, 6.136-b John Sealy Annex, Galveston, TX 77555-0534 | 2020-05-01 |
| 1326672635 | Starnes Surgical Associates Pllc | Surgery | 106 W Young St, Howe, TX 75459-4690 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
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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.