Provider Demographics
NPI:1417909508
Name:GASLIGHT AMBULATORY SURGERY CENTER LP
Entity Type:Organization
Organization Name:GASLIGHT AMBULATORY SURGERY CENTER LP
Other - Org Name:THE SURGERY CENTER AT GASLIGHT MEDICAL PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-473-7000
Mailing Address - Street 1:117 GASLIGHT MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-3150
Mailing Address - Country:US
Mailing Address - Phone:936-631-6000
Mailing Address - Fax:936-631-6082
Practice Address - Street 1:117 GASLIGHT MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3150
Practice Address - Country:US
Practice Address - Phone:936-631-6000
Practice Address - Fax:936-631-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008193261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ASC265Medicare ID - Type Unspecified