MEDICARE: SAGUARO ANESTHESIA ASSOCIATES PA

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
1	174400000X	Specialist	H6622	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00R65H	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1982740031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGUARO ANESTHESIA ASSOCIATES PA

Provider Business Mailing Address
First Line	:	9114 MCPHERSON RD STE 2508
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6511
Country	:	US
Telephone Number	:	956-717-2962
Fax Number	:	956-717-0069

Provider Business Practice Location Address
First Line	:	9114 MCPHERSON RD STE 2508
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78045-6511
Country	:	US
Telephone Number	:	956-717-2962
Fax Number	:	956-717-0069

Authorized Official
Title or Position	:	MEDICAL DOCTOR
Name	:	DR. JUDSON JEFFREY SOMERVILLE
Credential	:	M. D.
Telephone Number	:	956-717-2962

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	02/25/2015

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