{"npi":"1780163378","type":"NPI-2","status":"active","name":{"display":"Eastlake Surgical Associates, LLC","other":[],"organization_name":"EASTLAKE SURGICAL ASSOCIATES, LLC","authorised_official":"Tiffany Moreland"},"specialty":{"primary_taxonomy":"363AS0400X","primary_taxonomy_description":"Surgical Physician Assistant","slug":"surgical-physician-assistant","schema_org_specialty":null,"all":[{"code":"363AS0400X","description":"Surgical Physician Assistant","primary":true,"state":"TX","license":"SA00639"}]},"addresses":[{"purpose":"LOCATION","street_1":"2007 SHASTA RIDGE DR","city":"CONROE","state":"TX","postal_code":"773044697","country_code":"US","phone":"9364447071"},{"purpose":"MAILING","street_1":"2007 SHASTA RIDGE DR","city":"CONROE","state":"TX","postal_code":"773044697","country_code":"US","phone":"9364447071"}],"license":{"state":"TX","number":"SA00639"},"identifiers":[],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2018-08-14","last_updated":"2022-03-30","_meta":{"source":"NPPES","snapshot_date":"2022-03-30","doc_url":"https://findmynpi.com/api"}}