| City Of El Paso Texas | |
|
5115 El Paso Dr Ste B El Paso TX 79905-2818 | |
| (915) 212-6609 | |
| (915) 212-0172 |
| Full Name | City Of El Paso Texas |
|---|---|
| Speciality | Public Health or Welfare |
| Location | 5115 El Paso Dr Ste B, El Paso, Texas |
| Authorized Official Name and Position | Robert Cortinas (CFO) |
| Authorized Official Contact | 9152121067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| City Of El Paso Texas 5115 El Paso Dr Ste A El Paso TX 79905-2818 Ph: (915) 212-6512 | City Of El Paso Texas 5115 El Paso Dr Ste B El Paso TX 79905-2818 Ph: (915) 212-6609 |
| NPI Number | 1235142423 |
|---|---|
| Provider Enumeration Date | 08/15/2006 |
| Last Update Date | 08/03/2022 |
| Medicare PECOS PAC ID | 9032003199 |
|---|---|
| Medicare Enrollment ID | O20040210000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235142423 | NPI | - | NPPES |
| 065086301 | Medicaid | TX | |
| 120978503 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Secondary |
| 251K00000X | Public Health Or Welfare | (* (Not Available)) | Primary |
| Provider Name | Juan B Figueroa Casas |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699710889 PECOS PAC ID: 4082622089 Enrollment ID: I20060403000544 |
| Provider Name | Luis G Escobedo |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1851493605 PECOS PAC ID: 4789847088 Enrollment ID: I20120524000302 |
| Provider Name | Annette Romero Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316451081 PECOS PAC ID: 4789050659 Enrollment ID: I20221018000690 |
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