Provider Demographics
NPI:1154421386
Name:TWO RIVERS SURGERY CENTER, P.A.
Entity type:Organization
Organization Name:TWO RIVERS SURGERY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:956-668-8585
Mailing Address - Street 1:2101 CORNERSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8301
Mailing Address - Country:US
Mailing Address - Phone:956-668-8585
Mailing Address - Fax:956-578-0303
Practice Address - Street 1:2101 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8301
Practice Address - Country:US
Practice Address - Phone:956-668-8585
Practice Address - Fax:956-578-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2720261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH020AOtherBLUE CROSS BLUE SHIELD