Provider Demographics
NPI:1922862788
Name:MOUNTAIN WESTSTAR SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:MOUNTAIN WESTSTAR SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:713-498-5292
Mailing Address - Street 1:3909 N MESA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1534
Mailing Address - Country:US
Mailing Address - Phone:915-532-2222
Mailing Address - Fax:
Practice Address - Street 1:3909 N MESA ST STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1534
Practice Address - Country:US
Practice Address - Phone:915-532-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical