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EASTLAKE SURGICAL ASSOCIATES, LLC
NPI 1780163378
Physician Assistant - Surgical in Conroe, TX

Active since August 14, 2018
2007 SHASTA RIDGE DR, CONROE, TX 77304(936) 444-7071 Get Directions Write a Review

NPPES record last updated: March 30, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Eastlake Surgical Associates, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTLAKE SURGICAL ASSOCIATES, LLC (NPI 1780163378) is a healthcare organization registered as a surgical in Conroe, Texas and active in the NPI registry since August 2018. The organization lists Tiffany Brooke Moreland, Licensed Surgical Assistant, as its authorized official.

NPPES Registry Identity

NPI1780163378
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameEASTLAKE SURGICAL ASSOCIATES, LLC
Location Address2007 SHASTA RIDGE DRConroe, TX 77304-4697
Mailing Address2007 Shasta Ridge DrConroe, TX 77304-4697 · (936) 444-7071
Phone(936) 444-7071
Organization SubpartNo
Authorized OfficialTiffany Brooke MorelandLicensed Surgical Assistant · (936) 444-7071
Enumeration DateAugust 14, 2018
Last NPPES UpdateMarch 30, 2022
NPPES CertifiedJuly 30, 2020
✔ NPI 1780163378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in TX · SA00639
2007 SHASTA RIDGE DR, Conroe, TX 77304
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TIFFANY B. MORELAND LSA, CSFA
Physician Assistant (Surgical)
2007 SHASTA RIDGE DR
CONROE, TX 77304
Montgomery County (936) 444-7071

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastlake Surgical Associates, LLC's NPI number?

The NPI number for Eastlake Surgical Associates, LLC is 1780163378. It was assigned to this organization in the NPPES registry on August 14, 2018.

Where is Eastlake Surgical Associates, LLC located?

Eastlake Surgical Associates, LLC is located at 2007 Shasta Ridge Dr, Conroe, TX 77304. The listed phone number is (936) 444-7071.

What is Eastlake Surgical Associates, LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Eastlake Surgical Associates, LLC was last updated on March 30, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.