Provider Demographics
NPI:1316214158
Name:PLACE OF THE PEOPLE AMBULATORY SURGERY CENTER LLP
Entity type:Organization
Organization Name:PLACE OF THE PEOPLE AMBULATORY SURGERY CENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOMAN-MOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-794-8870
Mailing Address - Street 1:10410 MEDICAL LOOP
Mailing Address - Street 2:UNIT 4A
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6671
Mailing Address - Country:US
Mailing Address - Phone:956-462-6038
Mailing Address - Fax:956-462-6039
Practice Address - Street 1:10410 MEDICAL LOOP
Practice Address - Street 2:UNIT 4A
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6671
Practice Address - Country:US
Practice Address - Phone:956-462-6038
Practice Address - Fax:956-462-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8825207L00000X
TXK6333207Y00000X
TX130147261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX332297601Medicaid
TX130147OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES