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GENERAL AND VASCULAR SURGERY OF ENNIS PA NPI 1679564124


NPI Information

NPI: 1679564124
Provider Name: GENERAL AND VASCULAR SURGERY OF ENNIS PA
Classification: Surgery - 208600000X
Entity Type: Organization
Address:
802 W LAMPASAS ST
ENNIS, TX
ZIP 75119
Phone: (972) 878-4700
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GENERAL AND VASCULAR SURGERY OF ENNIS PA is a surgery in Ennis, TX. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. GENERAL AND VASCULAR SURGERY OF ENNIS PA NPI is 1679564124. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

802 W LAMPASAS ST
ENNIS, TX
ZIP 75119-500
Phone: (972) 878-4700
Fax: (972) 878-2238

The provider's authorized official is John M Sullivan .
The authorized official title is Owner and has the following contact phone number (972) 878-4700.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 7/21/2022.


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
1208600000XSurgeryTEXASYes

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
1159614002MEDICAIDTEXAS
200266VOTHERTEXASMEDICARE PTAN

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: 5/5/2024

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