MEDICARE: DUNAMIS SURGICAL CENTERS PLLC

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
1	208600000X	Surgery Physician	N9450	TX

General Provider Information

NPI Number	:	1629316328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUNAMIS SURGICAL CENTERS PLLC

Provider Business Mailing Address
First Line	:	4655 COHEN AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4415
Country	:	US
Telephone Number	:	915-532-1800
Fax Number	:	888-694-2748

Provider Business Practice Location Address
First Line	:	4655 COHEN AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4415
Country	:	US
Telephone Number	:	915-532-1800
Fax Number	:	888-694-2748

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OLUWAMAYOWA FRANKLIN FAMILUA
Credential	:
Telephone Number	:	347-738-7467

Provider Enumeration Date	:	01/30/2013
Last Update Date	:	12/29/2021

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