| Alfredo H Arellano Pmhcns-bc Pa | |
|
1122 Montana Ave Ste A El Paso TX 79902-5510 | |
| (915) 307-5796 | |
| (915) 307-5822 |
| Full Name | Alfredo H Arellano Pmhcns-bc Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 1122 Montana Ave Ste A, El Paso, Texas |
| Authorized Official Name and Position | Alfredo Arellano (PRESIDENT) |
| Authorized Official Contact | 9153075796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alfredo H Arellano Pmhcns-bc Pa 1122 Montana Ave Ste A El Paso TX 79902-5510 Ph: (915) 307-5796 | Alfredo H Arellano Pmhcns-bc Pa 1122 Montana Ave Ste A El Paso TX 79902-5510 Ph: (915) 307-5796 |
| NPI Number | 1730745613 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 11/10/2022 |
| Certification Date | 10/31/2022 |
| Medicare PECOS PAC ID | 4385972108 |
|---|---|
| Medicare Enrollment ID | O20190817000397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730745613 | NPI | - | NPPES |
| 428152901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Alfredo H Arellano |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1851558266 PECOS PAC ID: 5294815924 Enrollment ID: I20090131000017 |
| Provider Name | Eduardo Mariscal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821747833 PECOS PAC ID: 2466849757 Enrollment ID: I20220505001769 |
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