Provider Demographics
NPI:1770842981
Name:COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE VARICOSE VEINS LASER CLINIC LAS CRUCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-577-0121
Mailing Address - Street 1:1300 MURCHISON DR
Mailing Address - Street 2:STE.110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4842
Mailing Address - Country:US
Mailing Address - Phone:915-577-0121
Mailing Address - Fax:
Practice Address - Street 1:3850 FOOTHILLS RD
Practice Address - Street 2:STE.6
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4632
Practice Address - Country:US
Practice Address - Phone:575-521-4920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty