Provider Demographics
NPI:1407807050
Name:EL PASO DAY SURGERY LLC
Entity Type:Organization
Organization Name:EL PASO DAY SURGERY LLC
Other - Org Name:EL PASO DAY SURGERY, L.P.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENETHA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-763-3893
Mailing Address - Street 1:1300 MURCHISON
Mailing Address - Street 2:STE 200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4838
Mailing Address - Country:US
Mailing Address - Phone:915-594-9333
Mailing Address - Fax:915-225-7651
Practice Address - Street 1:1300 MURCHISON
Practice Address - Street 2:STE 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-225-7603
Practice Address - Fax:915-225-7651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008139261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171201001Medicaid
TXHH053AOtherBLUE CROSS
TX171201001Medicaid
ASC233Medicare PIN