Provider Demographics
NPI:1497869267
Name:DOCTORS SURGERY CENTER, INC
Entity Type:Organization
Organization Name:DOCTORS SURGERY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LEHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-569-8278
Mailing Address - Street 1:5300 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1370
Mailing Address - Country:US
Mailing Address - Phone:936-569-8278
Mailing Address - Fax:936-569-0275
Practice Address - Street 1:5300 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1370
Practice Address - Country:US
Practice Address - Phone:936-569-8278
Practice Address - Fax:936-569-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000295261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1358OtherBLUE CROSS BLUE SHIELD
TX085940701Medicaid
TX490002475OtherRR MEDICARE
TXHH1358OtherBLUE CROSS BLUE SHIELD