MEDICARE: VASCULAR ACCESS CARE OF EL PASO PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0204X	Vascular & Interventional Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467042341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR ACCESS CARE OF EL PASO PLLC

Provider Business Mailing Address
First Line	:	PO BOX 411048
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-1048
Country	:	US
Telephone Number	:	610-644-8900
Fax Number	:	484-924-0053

Provider Business Practice Location Address
First Line	:	5407 N MESA ST STE 100
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5468
Country	:	US
Telephone Number	:	915-533-1789
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. HECTOR J. DIAZ-LUNA
Credential	:	MD
Telephone Number	:	915-533-1789

Provider Enumeration Date	:	01/25/2021
Last Update Date	:	03/23/2026

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