Organization
SURGERY AFFILIATE OF EL PASO, LLC
Active
Other names
Foundation Surgery Affiliate of El Paso, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
125 W. CASTELLANO DRIVE, EL PASO, TX 79912
(915) 532-8200
(915) 532-6979
Mailing address
125 W CASTELLANO DR, EL PASO, TX 79912-6108
(915) 532-8200
(915) 532-6979
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
006838
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0508630490
EL PASO THOMASON OUTSOURC
—
01
—
087960301
EL PASO FIRST HEALTH NET
—
05
—
087960301
—
TX
01
—
177741300
DEPT OF LABOR
—
01
—
490004280
MEDICARE RAILROAD
—
05
—
A9316
—
NM
01
—
BP08630490
BIEN VIVIR SENIOR HS
—
01
—
CH08630490
EL PASO FIRST CHIP
—
01
—
GH08630490
EL PASO FIRST GROUP HEALT
—
01
—
HH1522
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/05/2005
Last updated
09/13/2024
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