Provider Demographics
NPI:1073023065
Name:SOUTH TEXAS ASC, LLC
Entity Type:Organization
Organization Name:SOUTH TEXAS ASC, LLC
Other - Org Name:SOUTH TEXAS SURGICAL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LONERGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-695-2757
Mailing Address - Street 1:PO BOX 780849
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0849
Mailing Address - Country:US
Mailing Address - Phone:855-882-2849
Mailing Address - Fax:801-931-2044
Practice Address - Street 1:8122 DATAPOINT DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3264
Practice Address - Country:US
Practice Address - Phone:210-200-6392
Practice Address - Fax:210-200-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-04
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH404AOtherBCBS PROVIDER ID