| Organization Name: | RUSHLAND PARK SURGICENTER |
| NPI Number: | 1023122876 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | C MICHEL OLIVA (OWNER/MEDICAL DIRECTOR) |
| Mailing Address: | 4404 6th St Lubbock |
| State: | TX US |
| Postal Code: | 794164732 |
| Phone Number: | 8067913377 |
| Fax Number: | 8067913378 |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 05/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |