Provider Demographics
NPI:1528009453
Name:TGLP, LP
Entity Type:Organization
Organization Name:TGLP, LP
Other - Org Name:THE ENDOSCOPY CENTER OF TEXARKANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:H
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-792-8030
Mailing Address - Street 1:1920 MOORES LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4610
Mailing Address - Country:US
Mailing Address - Phone:903-791-8657
Mailing Address - Fax:903-791-8650
Practice Address - Street 1:1920 MOORES LN
Practice Address - Street 2:SUITE B
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4610
Practice Address - Country:US
Practice Address - Phone:903-791-8657
Practice Address - Fax:903-791-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008336261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical