Provider Demographics
NPI:1700080546
Name:LAREDO SPINE MEDICAL CENTER
Entity Type:Organization
Organization Name:LAREDO SPINE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-791-3733
Mailing Address - Street 1:6423 MCPHERSON RD
Mailing Address - Street 2:STE 9
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6179
Mailing Address - Country:US
Mailing Address - Phone:956-791-3733
Mailing Address - Fax:956-791-3724
Practice Address - Street 1:6423 MCPHERSON RD
Practice Address - Street 2:STE 9
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6179
Practice Address - Country:US
Practice Address - Phone:956-791-3733
Practice Address - Fax:956-791-3724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center