Provider Demographics
NPI:1275574154
Name:DOCTORS SURGERY CENTER OF TEXARKANA
Entity Type:Organization
Organization Name:DOCTORS SURGERY CENTER OF TEXARKANA
Other - Org Name:DOCTOR'S SURGERY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/M.D.
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-772-4440
Mailing Address - Street 1:3211 SUGAR HILL ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-9219
Mailing Address - Country:US
Mailing Address - Phone:870-772-4440
Mailing Address - Fax:870-772-7190
Practice Address - Street 1:3211 SUGAR HILL ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-9219
Practice Address - Country:US
Practice Address - Phone:870-772-4440
Practice Address - Fax:870-772-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3179261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR141621128Medicaid
TX145326801Medicaid
AR141621128Medicaid