Eastlake Surgical Associates, LLC
NPI 1780163378ActiveOrganization· Physician Assistant, Surgical· Conroe, TX
Physician Assistant, Surgical in Conroe, Texas, registered in NPPES in August 2018. The authorized official on file is Tiffany Brooke Moreland, LSA, Licensed Surgical Assistant.
Overview
| NPI | 1780163378 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 14, 2018 |
| Last updated in NPPES | Mar 30, 2022 |
| Certified by provider | Jul 30, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | SA00639 | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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