Provider Demographics
NPI:1528891090
Name:TLD ENDOSURGERY LLC
Entity type:Organization
Organization Name:TLD ENDOSURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TEXELL
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGORIA DUBOCQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-236-2099
Mailing Address - Street 1:PARQUE MEDITERRANEO CALLE CORCEGA D9
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1451 AVE DR ASHFORD
Practice Address - Street 2:HOSPITAL LOBBY SURGERY CLINIC
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-722-6544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty