Organization
NORTHEAST TEXAS SURGERY CENTER
Active
Other names
Northeast Texas Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PENNY JO BURNHAM RN (ASC DIRECTOR)
(903) 792-2108
Entity
Organization
Contact information
Practice address
1902 MOORES LN, SUITE B, TEXARKANA, TX 75503-4610
(903) 792-2108
(903) 792-0606
Mailing address
1902 MOORES LN, SUITE B, TEXARKANA, TX 75503-4610
(903) 792-2108
(903) 792-0606
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
008109
TX
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008678
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10517
AR BCBS
AR
05
—
126632128
—
AR
05
—
176285801
—
TX
01
—
HH1366
TX BCBS ID
TX
Enumeration date
12/16/2005
Last updated
08/12/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us