Provider Demographics
NPI:1124197165
Name:MCALLEN SURGICAL SPECIALTY CENTER LTD
Entity Type:Organization
Organization Name:MCALLEN SURGICAL SPECIALTY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-7202
Mailing Address - Street 1:1309 E RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1517
Mailing Address - Country:US
Mailing Address - Phone:956-631-7202
Mailing Address - Fax:956-631-3026
Practice Address - Street 1:1309 E RIDGE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1517
Practice Address - Country:US
Practice Address - Phone:956-631-7202
Practice Address - Fax:956-631-3026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007782261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1561OtherBCBS OF TEXAS
TX145785501Medicaid
TXASC117Medicare PIN