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EAST TEXAS CARDIOVASCULAR LABS LLC NPI 1003835265


NPI Information

NPI: 1003835265
Provider Name: EAST TEXAS CARDIOVASCULAR LABS LLC

Doing Business As: NACOGDOCHES SURGICAL CENTER LTD

Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1303 N MOUND ST
NACOGDOCHES, TX
ZIP 75961
Phone: (936) 560-1844
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EAST TEXAS CARDIOVASCULAR LABS LLC is an ambulatory surgical clinic center in Nacogdoches, TX. EAST TEXAS CARDIOVASCULAR LABS LLC NPI is 1003835265. The provider is registered as an organization entity type.
The provider Is Doing Business As Nacogdoches Surgical Center Ltd.

The provider's business location address is:

1303 N MOUND ST
NACOGDOCHES, TX
ZIP 75961-030
Phone: (936) 560-1844
Fax: (936) 564-5145

The provider's authorized official is Prabhakar R Guniganti .
The authorized official title is Owner and has the following contact phone number (936) 560-1844.

The enumeration date for this NPI number is 7/19/2006 and was last updated on 10/31/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical008031TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00194639MEDICARE ID-TYPE UNSPECIFIEDTEXASRAILROAD MEDICARE PROVIDE
2171256401MEDICAIDTEXAS
3HH058AOTHERTEXASBLUE CROSS PROVIDER #
4ASC228MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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