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General NPI Number Information
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NPI Number | 1215289129
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Entity Type | Organization
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Legal Business Name | RENAISSANCE SURGERY GROUP
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Dates
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Enumeration Date | 10/03/2012
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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 | 78539-9152
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Country | US
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Telephone | 956-362-3300
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Fax | 956-362-7684
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Provider Business Mailing Address
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Address Line | PO BOX 3989
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City | MCALLEN
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State | TX
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Zip | 78502-3989
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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 | 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 #2
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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 #3
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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 #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology 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 | 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 #6
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) 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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 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 #9
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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 #10
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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