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Organization
TEA OBS LLC
Active
Organization
TEA OBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CROOKE (ADMINISTRATOR)
(208) 342-5151
Entity
Organization
Contact information
Practice address
2620 S EAGLE RD, MERIDIAN, ID 83642-6704
(208) 342-5151
Mailing address
2620 S EAGLE RD, MERIDIAN, ID 83642-6704
(208) 342-5151
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0132X
Ophthalmologic Surgery Clinic/Center
—
—
Other
Enumeration date
09/05/2022
Last updated
08/22/2023
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