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NPI Code Detail

MEDICARE: SURGICAL PARTNERS OF LAS CRUCES, LLC

MEDICARE: SURGICAL PARTNERS OF LAS CRUCES, LLC
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/Center3332NM

General Provider Information

NPI Number : 1962671263
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGICAL PARTNERS OF LAS CRUCES, LLC
Provider Business Mailing Address
First Line : 1205 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4748
Country : US
Telephone Number : 575-522-6144
Fax Number : 575-522-6171
Provider Business Practice Location Address
First Line : 1205 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4748
Country : US
Telephone Number : 575-522-6144
Fax Number : 575-522-6171
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. DELILAH PRIETO
Credential :
Telephone Number : 575-522-6144
Provider Enumeration Date : 02/21/2008
Last Update Date : 11/03/2010

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