Provider Demographics
NPI:1811461841
Name:EMERGENCY SURGICAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:EMERGENCY SURGICAL ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:BIJU
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-788-8588
Mailing Address - Street 1:2705 DAMSEL BELLA BLVD
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-6169
Mailing Address - Country:US
Mailing Address - Phone:469-788-8545
Mailing Address - Fax:469-788-8545
Practice Address - Street 1:2705 DAMSEL BELLA BLVD
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056-6169
Practice Address - Country:US
Practice Address - Phone:469-788-8545
Practice Address - Fax:469-788-8545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-12
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty