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NPI Code Detail

MEDICARE: COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC

MEDICARE: COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1770842981
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC
Provider Business Mailing Address
First Line : 1300 MURCHISON DR
Second Line : STE.110
City : EL PASO
State : TX
Zip : 79902-4842
Country : US
Telephone Number : 915-577-0121
Fax Number :
Provider Business Practice Location Address
First Line : 3850 FOOTHILLS RD
Second Line : STE.6
City : LAS CRUCES
State : NM
Zip : 88011-4632
Country : US
Telephone Number : 575-521-4920
Fax Number :
Authorized Official
Title or Position : OWNER
Name : OSCAR GUZMAN
Credential :
Telephone Number : 915-577-0121
Provider Enumeration Date : 05/08/2012
Last Update Date : 10/27/2023

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Directions to “COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC ” Practice Location

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