Provider Demographics
NPI:1962475590
Name:WESLACO OPHTHALMOLOGY ASC LP
Entity Type:Organization
Organization Name:WESLACO OPHTHALMOLOGY ASC LP
Other - Org Name:THE EYE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF GENERAL PARTNER CORP.
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:1402 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6603
Mailing Address - Country:US
Mailing Address - Phone:956-968-6155
Mailing Address - Fax:956-968-8291
Practice Address - Street 1:1402 E 6TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6603
Practice Address - Country:US
Practice Address - Phone:956-968-6155
Practice Address - Fax:956-968-8291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007869261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXASC144Medicare PIN