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General NPI Number Information
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NPI Number | 1770842981
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC
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Dates
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Enumeration Date | 05/08/2012
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 3850 FOOTHILLS RD STE.6
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City | LAS CRUCES
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State | NM
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Zip | 88011-4632
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Country | US
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Telephone | 575-521-4920
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 MURCHISON DR STE.110
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City | EL PASO
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State | TX
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Zip | 79902-4842
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Country | US
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Telephone | 915-577-0121
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OSCAR GUZMAN
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Credential |
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Telephone | 915-577-0121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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