Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lakeside Surgery PA

Organization Surgery Physician · NPI 1831468800

Lakeside Surgery PA is a Surgery Physician in Rockwall, Texas. Licensed in Texas. Registered with an NPI since 2011.

Licensed in
TX
In the registry since
2011
Specialties on file
3
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4450 Tubbs Rd
Rockwall, TX 75032-6308
Phone: (972) 772-3290
Fax: (972) 722-3815
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence K6483 (TX)
Surgery Physician Taxonomy 208600000X · Licence J2983 (TX)
Surgery Physician Taxonomy 208600000X · Licence P6593 (TX)

Record details

NPI number1831468800
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Terri Phillip — Practice Manager · (972) 722-3290
NPI enumeratedDecember 21, 2011
Last updated in NPPESJune 20, 2018
Mailing address4450 Tubbs Rd, Rockwall, TX 75032-6308

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