NPI age
14 years
Enumerated 2011-12-21
● Active Type 2 · Organization
Lakeside Surgery PA
Lakeside Surgery PA is 1 of 3028 surgery organizations in Texas.
Primary specialty
Surgery
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Phillip
Practice Manager
Last NPPES update
2018-06-20
Source: monthly bulk 2026-05
How this organization compares
Across 3028 active surgery providers in Texas.
NPI age
14 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2011 → 2026
2011-12Enumerated in NPPES
2011
2026
Where they practice
Primary practice location
4450 Tubbs Rd
Rockwall, TX 750326308
Mailing address
4450 Tubbs Rd
Rockwall, TX 750326308
Authorized official
Terri R Phillip
Practice Manager
📞 9727223290
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Caraleigh Buxie, MD Surgery NPI 1952577546
- Colleen Kennedy, MD Surgery NPI 1508897810
- Katherine Makohon, M.D. Surgery NPI 1952393415
- Jeffrey Stephens, M.D. Specialist NPI 1326097676
- Kiran Venincasa, M.D. Surgery NPI 1821477274
Specialties
-
Surgery PrimaryA 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...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 1326097676 | NPI # |
| 01 (TX) | 1952393415 | NPI # |
| 01 (TX) | J2983 | TX LICENSE |
| 01 (TX) | K6483 | TX LICENSE |
| 01 (TX) | P6593 | STATE LICENSE |
Practice context
Multi-provider organization. 5 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 →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.