Organization
SURGERY MANAGEMENT GROUP LLC
Active
Other names
GALLUP SURGERY CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
TERRENCE JOHNSON (OWNER)
(469) 235-5588
Entity
Organization
Contact information
Practice address
1808 E AZTEC AVE STE 2, GALLUP, NM 87301-4946
(469) 235-5588
(866) 600-7772
Mailing address
1200 E COLLINS BLVD, RICHARDSON, TX 75081-2457
(469) 235-5588
(866) 600-7772
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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