Provider Demographics
NPI:1396703633
Name:EL PASO SURGICAL ASSOCIATES, P.A.
Entity type:Organization
Organization Name:EL PASO SURGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-543-9600
Mailing Address - Street 1:1700 CURIE DR
Mailing Address - Street 2:STE 1500
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2905
Mailing Address - Country:US
Mailing Address - Phone:915-543-9600
Mailing Address - Fax:915-543-9700
Practice Address - Street 1:1700 CURIE DR
Practice Address - Street 2:STE 1500
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2905
Practice Address - Country:US
Practice Address - Phone:915-543-9600
Practice Address - Fax:915-543-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U91ZOtherBCBS PROVIDER ID
00U91ZMedicare ID - Type UnspecifiedMEDICARE ID