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NPI Code Detail

MEDICARE: EL DORADO SURGERY CENTER LP

MEDICARE: EL DORADO SURGERY CENTER LP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2OSC10686OTHERAZSTATE LICENSE

General Provider Information

NPI Number : 1437191731
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL DORADO SURGERY CENTER LP
Provider Business Mailing Address
First Line : PO BOX 848236
Second Line :
City : DALLAS
State : TX
Zip : 75284-8236
Country : US
Telephone Number : 520-877-4254
Fax Number : 877-319-4035
Provider Business Practice Location Address
First Line : 2121 N CRAYCROFT RD BLDG 8
Second Line :
City : TUCSON
State : AZ
Zip : 85712-2801
Country : US
Telephone Number : 520-877-4254
Fax Number : 877-319-4035
Authorized Official
Title or Position : DIRECTOR OF PROVIDER ENROLLMENT
Name : KRISTINA MUSIC
Credential :
Telephone Number : 615-465-7377
Provider Enumeration Date : 06/12/2006
Last Update Date : 02/21/2024

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Directions to “EL DORADO SURGERY CENTER LP ” Practice Location

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