| Desert Star Behavioral Health, Llc | |
|
550 N. Peyton Rd. Ste. 105 El Paso TX 79928 | |
| (915) 490-3116 | |
| (915) 288-2681 |
| Full Name | Desert Star Behavioral Health, Llc |
|---|---|
| Speciality | Case Management |
| Location | 550 N. Peyton Rd., El Paso, Texas |
| Authorized Official Name and Position | Joyce Gonzalez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9154903116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Desert Star Behavioral Health, Llc 550 N. Peyton Rd. Ste. 105 El Paso TX 79928 Ph: (915) 490-3116 | Desert Star Behavioral Health, Llc 550 N. Peyton Rd. Ste. 105 El Paso TX 79928 Ph: (915) 490-3116 |
| NPI Number | 1972146496 |
|---|---|
| Provider Enumeration Date | 10/28/2019 |
| Last Update Date | 01/27/2023 |
| Certification Date | 01/24/2023 |
| Medicare PECOS PAC ID | 3173931334 |
|---|---|
| Medicare Enrollment ID | O20210428001081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972146496 | NPI | - | NPPES |
| Provider Name | Jorge N Avila |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255538187 PECOS PAC ID: 6800038407 Enrollment ID: I20160727000289 |
| Provider Name | Krystal Aileen Kalt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508499260 PECOS PAC ID: 5395174858 Enrollment ID: I20200407000193 |
| Provider Name | Andres Baeza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003454174 PECOS PAC ID: 4981033206 Enrollment ID: I20200407001470 |
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