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Organization
SURGERY AFFILIATE OF EL PASO, LLC
Active
Organization
SURGERY AFFILIATE OF EL PASO, LLC
Active
Other names
Foundation Surgery Affiliate of El Paso, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
125 W. CASTELLANO DRIVE, EL PASO, TX 79912
(915) 532-8200
(915) 532-6979
Mailing address
125 W CASTELLANO DR, EL PASO, TX 79912-6108
(915) 532-8200
(915) 532-6979
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
006838
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0508630490
EL PASO THOMASON OUTSOURC
—
01
—
087960301
EL PASO FIRST HEALTH NET
—
05
—
087960301
—
TX
01
—
177741300
DEPT OF LABOR
—
01
—
490004280
MEDICARE RAILROAD
—
05
—
A9316
—
NM
01
—
BP08630490
BIEN VIVIR SENIOR HS
—
01
—
CH08630490
EL PASO FIRST CHIP
—
01
—
GH08630490
EL PASO FIRST GROUP HEALT
—
01
—
HH1522
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/05/2005
Last updated
09/13/2024
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