| Renaissance Surgery Group | |
|
5501 S Mccoll Rd Edinburg TX 78539-9152 | |
| (956) 362-3300 | |
| (956) 362-7684 |
| Full Name | Renaissance Surgery Group |
|---|---|
| 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 Surgery Group Po Box 3989 Mcallen TX 78502-3989 Ph: (956) 362-2171 | Renaissance Surgery Group 5501 S Mccoll Rd Edinburg TX 78539-9152 Ph: (956) 362-3300 |
| NPI Number | 1215289129 |
|---|---|
| Provider Enumeration Date | 10/03/2012 |
| Last Update Date | 08/29/2022 |
| Medicare PECOS PAC ID | 9234384769 |
|---|---|
| Medicare Enrollment ID | O20130306000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215289129 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Leslie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245378124 PECOS PAC ID: 3375442775 Enrollment ID: I20040105000772 |
| Provider Name | Manuel G Espinoza |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447454004 PECOS PAC ID: 0244394237 Enrollment ID: I20090206000152 |
| Provider Name | Juan C Prieto |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609071489 PECOS PAC ID: 0749338929 Enrollment ID: I20090427000525 |
| Provider Name | Henry E Ruiz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245236348 PECOS PAC ID: 9830220086 Enrollment ID: I20100701000538 |
| Provider Name | Alexander J Feigl |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1528064623 PECOS PAC ID: 2264335843 Enrollment ID: I20100715000603 |
| Provider Name | Hector Escajeda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184991564 PECOS PAC ID: 1759372683 Enrollment ID: I20120223000674 |
| Provider Name | Gaudencio Olgin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790049732 PECOS PAC ID: 7517113574 Enrollment ID: I20140917002916 |
| Provider Name | Gustavo V Villegas |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710207378 PECOS PAC ID: 4082921457 Enrollment ID: I20150917000089 |
| Provider Name | Andrew J Marks |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679702377 PECOS PAC ID: 0143492876 Enrollment ID: I20160712000235 |
| Provider Name | David Alonzo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558689901 PECOS PAC ID: 1052628153 Enrollment ID: I20170531000652 |
| Provider Name | Amanda Lynn Mure |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235405812 PECOS PAC ID: 7911275235 Enrollment ID: I20170609000822 |
| Provider Name | Griselda Escajeda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902389307 PECOS PAC ID: 5799018347 Enrollment ID: I20190613000622 |
| Provider Name | Thomas Novak |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326218017 PECOS PAC ID: 7719128248 Enrollment ID: I20200214001266 |
| Provider Name | Diego Andres Aguilar Palacios |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447613112 PECOS PAC ID: 9830481555 Enrollment ID: I20220722002970 |
| Provider Name | Erica Marie Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942947593 PECOS PAC ID: 9133504483 Enrollment ID: I20220922001568 |
| Provider Name | Pete Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225708233 PECOS PAC ID: 4183000318 Enrollment ID: I20220926002085 |
| Provider Name | Natalia Hernandez Bustos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730542432 PECOS PAC ID: 1456719731 Enrollment ID: I20230619000358 |
| Provider Name | Ricardo Antonio Arceo Olaiz |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1851066278 PECOS PAC ID: 5698179653 Enrollment ID: I20230929003126 |
| Provider Name | Daniel Todd Lybbert |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790279941 PECOS PAC ID: 1052668027 Enrollment ID: I20240524003554 |
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