GOOD SHEPHERD AMBULATORY SURGICAL CENTER LTD NPI 1255317384

NPI Information

NPI: 1255317384
Provider Name: GOOD SHEPHERD AMBULATORY SURGICAL CENTER LTD
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
703 E MARSHALL AVE
SUITE 2000
LONGVIEW, TX
ZIP 75601
Phone: (903) 315-5300
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GOOD SHEPHERD AMBULATORY SURGICAL CENTER LTD is an ambulatory surgical clinic center in Longview, TX. GOOD SHEPHERD AMBULATORY SURGICAL CENTER LTD NPI is 1255317384. The provider is registered as an organization entity type.

The provider's business location address is:

703 E MARSHALL AVE
SUITE 2000
LONGVIEW, TX
ZIP 75601-500
Phone: (903) 315-5300
Fax: (903) 315-5301

The provider's authorized official is Jerry D Adair .
The authorized official title is President/ceo and has the following contact phone number (903) 315-2000.

The enumeration date for this NPI number is 12/20/2005 and was last updated on 5/13/2009.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical	7792	TEXAS	Yes

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
1	=========	OTHER	TEXAS	TAX IDENTIFICATION NUMBER
2	ASC120	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
3	147239101	MEDICAID	TEXAS
4	HH1354	OTHER	TEXAS	BCBS OF TEXAS
5	122076	OTHER	TEXAS	CHIPS/SUPERIOR HEALTH PLA
6	490005292	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	RAILROAD

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

NPI Synchronization or Removal

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