Organization
MISSION DOCTORS GROUP
Active
Other names
Mission Heart and Vascular, The Weight Loss Surgery Center at Mission Regional Medical Center, Monarch Clinic, Restore Joint & Spine
Organization subpart
No
Provider details
NPI number
Authorized official
LESTER EDWARD SURROCK CPA (CFO)
(956) 323-9106
Entity
Organization
Contact information
Practice address
910 S BRYAN RD STE 103, MISSION, TX 78572-6615
(956) 598-7000
(956) 598-7001
Mailing address
910 S BRYAN RD STE 103, MISSION, TX 78572-6615
(956) 598-7000
(956) 598-7001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207RI0011X
Interventional Cardiology Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033DE
BCBS PIN
TX
05
—
080646502
—
TX
Enumeration date
08/02/2006
Last updated
11/06/2024
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