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General NPI Number Information
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NPI Number | 1992181184
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Entity Type | Organization
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Legal Business Name | TC SURGICAL PSC
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | AVENIDA PONCE DE LEON PARADA 37 1/2
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City | SAN JUAN
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State | PR
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Zip | 00919-1227
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Country | US
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Telephone | 787-758-2000
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Fax | 787-771-7952
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Provider Business Mailing Address
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Address Line | P.O. BOX 10189
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City | SAN JUAN
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State | PR
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Zip | 00908-0189
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Country | US
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Telephone | 787-758-2000
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Fax | 787-771-7952
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Authorized Official
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Title or Position | PRESIDENT, SECRETARY, TREASURER
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Name | DR. VANGIE A TEXIDOR
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Credential | M.D.
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Telephone | 787-342-1294
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 18768
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License Number State | PR
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