Provider Demographics
NPI:1730139957
Name:DRS. EDWARD E. & CORAZON P. QUIROS, M.D., P.A.
Entity Type:Organization
Organization Name:DRS. EDWARD E. & CORAZON P. QUIROS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:QUIROS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-273-7596
Mailing Address - Street 1:PO BOX 5284
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79008-5284
Mailing Address - Country:US
Mailing Address - Phone:806-273-7596
Mailing Address - Fax:806-274-3622
Practice Address - Street 1:600 W 3RD ST
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4008
Practice Address - Country:US
Practice Address - Phone:806-273-7596
Practice Address - Fax:806-274-3622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2384207VX0000X
TXE9342208600000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083323801Medicaid
TXB25720Medicare UPIN
TXC20752Medicare UPIN
TX083323801Medicaid