NPI age
20 years
Enumerated 2005-12-16
● Active Type 2 · Organization
Northeast Texas Surgery Center
Northeast Texas Surgery Center is 1 of 1647 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Burnham
Asc Director
Last NPPES update
2008-08-12
Source: monthly bulk 2026-05
How this organization compares
Across 1647 active clinic/center providers in Texas.
NPI age
20 years
↑ 4 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2005 → 2026
2005-12Enumerated in NPPES
2005
2026
Where they practice
Primary practice location
1902 Moores Ln, Suite B
Texarkana, TX 755034610
Mailing address
1902 Moores Ln, Suite B
Texarkana, TX 755034610
Authorized official
Penny Jo Burnham, RN
Asc Director
📞 9037922108
Individual providers at this organization
7 individual providers on file at this primary practice address.
- Kaci Drumm, APRN, FNP-BC Nurse Practitioner NPI 1447871124
- Shivani Gaitonde, MD Urology NPI 1962962977
- Cordell Klein, MD Urology NPI 1730183534
- Jessie Liang, MD Urology NPI 1790105898
- Christopher Payne, MD Urology NPI 1558363507
- Jason Pickelman, MD Urology NPI 1538163910
- Glen Rountree, MD Urology NPI 1144222100
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (AR) | 10517 | AR BCBS |
| 01 (TX) | HH1366 | TX BCBS ID |
| 05 (AR) | 126632128 | |
| 05 (TX) | 176285801 |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Northeast Texas Surgical Center
Practice context
Multi-provider organization. 7 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.