Provider Demographics
NPI:1871610212
Name:PORT ARTHUR SURGICAL ASSOCIATION
Entity type:Organization
Organization Name:PORT ARTHUR SURGICAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-721-5150
Mailing Address - Street 1:3820 HIGHWAY 365
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-7543
Mailing Address - Country:US
Mailing Address - Phone:409-721-5150
Mailing Address - Fax:409-721-6102
Practice Address - Street 1:3820 HIGHWAY 365
Practice Address - Street 2:SUITE 200
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-7543
Practice Address - Country:US
Practice Address - Phone:409-721-5150
Practice Address - Fax:409-721-6102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty