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General NPI Number Information
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NPI Number | 1962609560
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Entity Type | Organization
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Legal Business Name | FRONT RANGE ENDOSCOPY CENTERS, LLC
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 719 N CASCADE AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-3205
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Country | US
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Telephone | 719-433-7224
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Fax | 719-433-7225
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Provider Business Mailing Address
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Address Line | 2920 N CASCADE AVE STE 301
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-6265
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Country | US
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Telephone | 719-636-1201
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Fax | 719-955-0986
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BHAKTASHARAN C PATEL
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Credential | M.D.
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Telephone | 719-433-7224
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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 | 16C871
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License Number State | CO
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