Organization
LAREDO REGIONAL MEDICAL CENTER
Active
Other names
Doctors Hospital Anesthesia
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELADIO MONTALVO (CFO)
(956) 523-2086
Entity
Organization
Contact information
Practice address
10700 MCPHERSON AVE, LAREDO, TX 78045-6268
(956) 523-2619
Mailing address
7917 MCPHERSON RD, SUITE 205, PMB # 233, LAREDO, TX 78045-2811
(956) 523-2619
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0041KP
BCBS
TX
01
—
00C82R
BCBS
TX
05
—
160688102
—
TX
01
—
DA5648
RAILROAD
TX
Enumeration date
06/29/2006
Last updated
11/07/2008
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