Organization
TEXAS UROGYNECOLOGY & LASER SURGERY CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD W FARNAM M.D. (PRESIDENT)
(915) 487-2558
Entity
Organization
Contact information
Practice address
4501 N MESA ST, EL PASO, TX 79912-6101
(915) 533-5600
(915) 533-5604
Mailing address
4501 N MESA ST, EL PASO, TX 79912-6101
(915) 533-5600
(915) 533-5604
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0096SG
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/09/2009
Last updated
10/29/2021
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