Organization
SURGERY ASSOCIATES OF TEXARKANA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHEILA CLARK (OFFICE MANAGER)
(903) 792-6114
Entity
Organization
Contact information
Practice address
1920 GALLERIA OAKS DR, TEXARKANA, TX 75503-4619
(903) 792-6114
(903) 792-7876
Mailing address
1920 GALLERIA OAKS DR, TEXARKANA, TX 75503-4619
(903) 792-6114
(903) 792-7876
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A60J
TEXAS BLUE CROSS
TX
01
—
77868
LOUISIANA BLUE CROSS
LA
01
—
81394
ARK BLUE CROSS
AR
01
—
CS3854
TRAVELERS MEDICARE
TX
Enumeration date
05/04/2006
Last updated
04/17/2008
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