Organization
SAN ANGELO AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN ALLEN GUETLEIN (ADMINISTRATOR)
(325) 223-0555
Entity
Organization
Contact information
Practice address
3605 EXECUTIVE DR, SAN ANGELO, TX 76904-6884
(325) 223-0555
(325) 223-0909
Mailing address
3605 EXECUTIVE DR, SAN ANGELO, TX 76904-6884
(325) 223-0555
(325) 223-0909
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH0552A
BCBS NON-NETWORK PROVIDER
TX
Enumeration date
11/08/2005
Last updated
08/22/2020
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