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General NPI Number Information
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NPI Number | 1871814921
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Entity Type | Organization
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Legal Business Name | SURGICAL PARTNERS OF LAS CRUCES
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 1205 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-4748
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Country | US
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Telephone | 575-522-6144
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Fax | 575-522-6171
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Provider Business Mailing Address
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Address Line | 1205 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-4748
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Country | US
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Telephone | 575-522-6144
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Fax | 575-522-6171
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. DELILAH R PRIETO
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Credential |
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Telephone | 575-522-6144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 3020
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License Number State | NM
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