Provider Demographics
NPI:1790493641
Name:SOUTHWEST AMBULATORY SURGERY CENTER, PLLC
Entity Type:Organization
Organization Name:SOUTHWEST AMBULATORY SURGERY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIKEZIE
Authorized Official - Middle Name:CHIDIEBERE
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-373-9066
Mailing Address - Street 1:1508 N ZARAGOZA RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-8034
Mailing Address - Country:US
Mailing Address - Phone:915-373-9066
Mailing Address - Fax:915-298-5430
Practice Address - Street 1:3030 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-1014
Practice Address - Country:US
Practice Address - Phone:915-373-9066
Practice Address - Fax:915-298-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical