| Renaissance Providers | |
|
5501 S Mccoll Rd Edinburg TX 78539-9152 | |
| (956) 362-2171 | |
| (956) 362-2132 |
| Full Name | Renaissance Providers |
|---|---|
| Speciality | Clinic/Center |
| Location | 5501 S Mccoll Rd, Edinburg, Texas |
| Authorized Official Name and Position | Ada X Gonzalez (ADMINISTRATOR) |
| Authorized Official Contact | 9563622171 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Providers Po Box 4624 Mcallen TX 78502-4624 Ph: (956) 362-2171 | Renaissance Providers 5501 S Mccoll Rd Edinburg TX 78539-9152 Ph: (956) 362-2171 |
| NPI Number | 1336577477 |
|---|---|
| Provider Enumeration Date | 10/29/2013 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 3476877879 |
|---|---|
| Medicare Enrollment ID | O20150113000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336577477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Kip Owen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669477709 PECOS PAC ID: 3173506334 Enrollment ID: I20040609000590 |
| Provider Name | Jose M Marina |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992777460 PECOS PAC ID: 2163494402 Enrollment ID: I20040813000337 |
| Provider Name | Haissam S Elzaim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972723583 PECOS PAC ID: 7810074036 Enrollment ID: I20080411000201 |
| Provider Name | Sergio Rodriguez |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1528279924 PECOS PAC ID: 9133294010 Enrollment ID: I20080813000143 |
| Provider Name | Patrick W Sander |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427233394 PECOS PAC ID: 0941342679 Enrollment ID: I20100119000502 |
| Provider Name | Salvador Mendez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457355414 PECOS PAC ID: 0446168470 Enrollment ID: I20100226000580 |
| Provider Name | Jose R Carreras |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1801889324 PECOS PAC ID: 4789650813 Enrollment ID: I20100901000403 |
| Provider Name | Charles J Schwertner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811940786 PECOS PAC ID: 5698704153 Enrollment ID: I20101029000582 |
| Provider Name | Michael Serra Torres |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679733281 PECOS PAC ID: 1951467067 Enrollment ID: I20161011001087 |
| Provider Name | Jaime Villarreal |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427316132 PECOS PAC ID: 9739459645 Enrollment ID: I20170726001938 |
| Provider Name | Sujan Gogu |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1407268162 PECOS PAC ID: 8729357116 Enrollment ID: I20180912001243 |
| Provider Name | Crisela A Pate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508365479 PECOS PAC ID: 2860743747 Enrollment ID: I20180918000338 |
| Provider Name | Daniel A Romanelli |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245391168 PECOS PAC ID: 1153229273 Enrollment ID: I20200106000910 |
| Provider Name | Marshall Gillette |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790172211 PECOS PAC ID: 0446554711 Enrollment ID: I20210722003450 |
| Provider Name | Lesly Ivette Velez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194120378 PECOS PAC ID: 2860715158 Enrollment ID: I20210804002002 |
| Provider Name | Eric Wilkinson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407119399 PECOS PAC ID: 6305203837 Enrollment ID: I20230526002639 |
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