=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730139957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRS. EDWARD E. & CORAZON P. QUIROS, M.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2006
-----------------------------------------------------
Last Update Date | 12/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 W 3RD ST
-----------------------------------------------------
City | BORGER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79007-4008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-273-7596
-----------------------------------------------------
Fax | 806-274-3622
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5284
-----------------------------------------------------
City | BORGER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79008-5284
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-273-7596
-----------------------------------------------------
Fax | 806-274-3622
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | EDWARD E QUIROS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 806-273-7596
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0000X
-----------------------------------------------------
Taxonomy Name | Obstetrics Physician
-----------------------------------------------------
License Number | F2384
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2086S0105X
-----------------------------------------------------
Taxonomy Name | Surgery of the Hand (Surgery) Physician
-----------------------------------------------------
License Number | E9342
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | E9342
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------