Provider Demographics
NPI:1669593836
Name:SURGICAL ASSOCIATES OF BROWNSVILLE
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES OF BROWNSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:MIRIAM
Authorized Official - Last Name:ERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-541-6320
Mailing Address - Street 1:4770 N EXPRESSWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4120
Mailing Address - Country:US
Mailing Address - Phone:956-541-6320
Mailing Address - Fax:956-541-7889
Practice Address - Street 1:4770 N EXPRESSWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-4120
Practice Address - Country:US
Practice Address - Phone:956-541-6320
Practice Address - Fax:956-541-7889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7139174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX023367802Medicaid
TX126446703Medicaid
TX126446703Medicaid
TXE20504Medicare UPIN