| Renaissance Specialty Surgery | |
|
5501 S Mccoll Rd Edinburg TX 78539-5503 | |
| (956) 362-2171 | |
| (956) 362-3614 |
| Full Name | Renaissance Specialty Surgery |
|---|---|
| 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 Specialty Surgery Po Box 2975 Mcallen TX 78502-2975 Ph: (956) 362-2171 | Renaissance Specialty Surgery 5501 S Mccoll Rd Edinburg TX 78539-5503 Ph: (956) 362-2171 |
| NPI Number | 1174952907 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 8628291820 |
|---|---|
| Medicare Enrollment ID | O20140515000672 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174952907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Carlos Alberto Herrera |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467435982 PECOS PAC ID: 5890757439 Enrollment ID: I20041027000446 |
| Provider Name | Hector E Salcedo-dovi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679566525 PECOS PAC ID: 7012961469 Enrollment ID: I20050309000296 |
| Provider Name | Carlos Garcia Cantu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942234588 PECOS PAC ID: 0749274645 Enrollment ID: I20050329000819 |
| Provider Name | John G Orfanos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366476921 PECOS PAC ID: 1355259383 Enrollment ID: I20050329000833 |
| Provider Name | Edgar V Cruz-gonzalez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609952092 PECOS PAC ID: 0345232724 Enrollment ID: I20050406000484 |
| Provider Name | Victor Haddad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760568240 PECOS PAC ID: 7911991815 Enrollment ID: I20050817000439 |
| Provider Name | Raul Barreda |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881621365 PECOS PAC ID: 7911908116 Enrollment ID: I20070130000447 |
| Provider Name | Jose A Gonzalez |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1689709925 PECOS PAC ID: 5496783631 Enrollment ID: I20070731000618 |
| Provider Name | Lyuba Levine |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1730241217 PECOS PAC ID: 0042355851 Enrollment ID: I20100304000509 |
| Provider Name | Ricardo Martinez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609867308 PECOS PAC ID: 2264525963 Enrollment ID: I20101215000645 |
| Provider Name | Karen Jean Brooks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366476285 PECOS PAC ID: 5698958932 Enrollment ID: I20110324000532 |
| Provider Name | Roy D Edwards |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255530309 PECOS PAC ID: 9335382076 Enrollment ID: I20160712000552 |
| Provider Name | Jeffrey James Skubic |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609169994 PECOS PAC ID: 5597033068 Enrollment ID: I20180925001479 |
| Provider Name | San Juanita Salinas-avila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023504131 PECOS PAC ID: 0840536181 Enrollment ID: I20190108002185 |
| Provider Name | Michael Robert Warren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821655770 PECOS PAC ID: 5799010237 Enrollment ID: I20190705000794 |
| Provider Name | Lisa Chapa |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1487095691 PECOS PAC ID: 4183905144 Enrollment ID: I20190916003584 |
| Provider Name | Cruz Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477014132 PECOS PAC ID: 6204167737 Enrollment ID: I20191014002236 |
| Provider Name | Sylvia Edith Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992310783 PECOS PAC ID: 4880952183 Enrollment ID: I20201207000560 |
| Provider Name | Patricia Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437709144 PECOS PAC ID: 0941690465 Enrollment ID: I20211124000069 |
| Provider Name | Amy Lynn Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467736389 PECOS PAC ID: 3870984743 Enrollment ID: I20220104000424 |
| Provider Name | Cera Georgene Kroenke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306371711 PECOS PAC ID: 0547640864 Enrollment ID: I20220705001638 |
| Provider Name | Alejandro Garza |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1073990990 PECOS PAC ID: 3072809615 Enrollment ID: I20220709000837 |
| Provider Name | Jessica Dina Vinluan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609593698 PECOS PAC ID: 8224405527 Enrollment ID: I20221028002247 |
| Provider Name | Theresa Adelaida Clinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477268829 PECOS PAC ID: 1850752148 Enrollment ID: I20230802004124 |
| Provider Name | Olivia Chinyere Okonkwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972369312 PECOS PAC ID: 1951742170 Enrollment ID: I20240517003031 |
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