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NPI Code Detail

MEDICARE: LASER SURGICAL SOLUTIONS, RGV LLC

MEDICARE: LASER SURGICAL SOLUTIONS, RGV 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
1207Q00000XFamily Medicine Physician
2208600000XSurgery Physician
32086S0129XVascular Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1519013OTHERTXMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790131597
Entity Type Code : Organization
Provider Name (Legal Business Name) : LASER SURGICAL SOLUTIONS, RGV LLC
Provider Business Mailing Address
First Line : 909 N JACKSON RD
Second Line :
City : MCALLEN
State : TX
Zip : 78501-9357
Country : US
Telephone Number : 956-992-9161
Fax Number : 956-992-9174
Provider Business Practice Location Address
First Line : 909 N JACKSON RD
Second Line :
City : MCALLEN
State : TX
Zip : 78501-9357
Country : US
Telephone Number : 956-992-9161
Fax Number : 956-992-9174
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : JOHN W HOVORKA
Credential : MD
Telephone Number : 956-992-9161
Provider Enumeration Date : 05/11/2016
Last Update Date : 01/03/2020

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Directions to “LASER SURGICAL SOLUTIONS, RGV LLC ” Practice Location

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