| Texas Neurodiagnostic Headache & Sleep Disorder Center, Pa | |
|
2311 N Mesa St Ste F El Paso TX 79902-3575 | |
| (915) 544-6400 | |
| (915) 544-2836 |
| Full Name | Texas Neurodiagnostic Headache & Sleep Disorder Center, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2311 N Mesa St Ste F, El Paso, Texas |
| Authorized Official Name and Position | Boris Kaim (PRESIDENT) |
| Authorized Official Contact | 9155446400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Neurodiagnostic Headache & Sleep Disorder Center, Pa 2311 N Mesa St Ste F El Paso TX 79902-3575 Ph: (915) 444-6400 | Texas Neurodiagnostic Headache & Sleep Disorder Center, Pa 2311 N Mesa St Ste F El Paso TX 79902-3575 Ph: (915) 544-6400 |
| NPI Number | 1063591675 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 01/13/2014 |
| Medicare PECOS PAC ID | 7113056169 |
|---|---|
| Medicare Enrollment ID | O20100601000165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063591675 | NPI | - | NPPES |
| 1326054164 | Other | TX | DR. INDIVIDUAL NPI NUMBER |
| 085590001 | Medicaid | TX | |
| 136626206 | Medicaid | TX | |
| 81Z601 | Other | TX | BC/BS TX PROVIDER NUMBER |
| Provider Name | Boris Kaim |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326054164 PECOS PAC ID: 6507995560 Enrollment ID: I20100601000298 |
| Provider Name | Carlos Fuentes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740666569 PECOS PAC ID: 0840540274 Enrollment ID: I20180906000832 |
| Provider Name | Ezra Samuel Elkayam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023091477 PECOS PAC ID: 2567413404 Enrollment ID: I20210830000884 |
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