Provider Demographics
NPI:1205454006
Name:GOLDEN TRIANGLE SURGERY CENTER, LLC
Entity type:Organization
Organization Name:GOLDEN TRIANGLE SURGERY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TALBOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-351-5304
Mailing Address - Street 1:3560 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4614
Mailing Address - Country:US
Mailing Address - Phone:409-835-7070
Mailing Address - Fax:
Practice Address - Street 1:3560 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4614
Practice Address - Country:US
Practice Address - Phone:409-835-7070
Practice Address - Fax:409-835-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty