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General NPI Number Information
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NPI Number | 1174952907
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Entity Type | Organization
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Legal Business Name | RENAISSANCE SPECIALTY SURGERY
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Dates
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Enumeration Date | 11/02/2013
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 5501 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-5503
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Country | US
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Telephone | 956-362-2171
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Fax | 956-362-3614
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Provider Business Mailing Address
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Address Line | PO BOX 2975
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City | MCALLEN
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State | TX
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Zip | 78502-2975
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Country | US
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Telephone | 956-362-2171
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Fax | 956-362-3614
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. ADA X GONZALEZ
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Credential |
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Telephone | 956-362-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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