NORTHEAST BAPTIST SURGERY CENTER LLC NPI 1407853740

NPI Information

  • NPI: 1407853740
  • Provider Name: NORTHEAST BAPTIST SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: VILLAGE SPECIALTY SURGICAL CENTER
  • Address: 8715 VILLAGE DR
    SUITE 200
    SAN ANTONIO, TX
    ZIP 78217
  • Phone: (210) 477-1775

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NPI Details

NORTHEAST BAPTIST SURGERY CENTER LLC is an ambulatory surgical clinic center in San Antonio, TX. NORTHEAST BAPTIST SURGERY CENTER LLC NPI is 1407853740. The provider is registered as an organization entity type.
The provider Is Doing Business As Village Specialty Surgical Center.

The provider's business location address is:

8715 VILLAGE DR
SUITE 200
SAN ANTONIO, TX
ZIP 78217
Phone: (210) 477-1775
Fax: (210) 477-1794

The provider's authorized official is Misty Diane Walton .
The authorized official title is Administrator and has the following contact phone number (210) 477-1788.

The enumeration date for this NPI number is 7/1/2005 and was last updated on 11/5/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical000369TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ASC014MEDICARE UPINTEXAS
2087944701MEDICAIDTEXAS
3490003869OTHERTEXASRAILROAD MEDICARE
4ASC014MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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