MEDICARE: PAN AMERICAN GENERAL HOSPITAL

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	282N00000X	General Acute Care Hospital	000252	TX

General Provider Information

NPI Number	:	1679588396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAN AMERICAN GENERAL HOSPITAL

Provider Business Mailing Address
First Line	:	1221 N COTTON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3015
Country	:	US
Telephone Number	:	915-496-9600
Fax Number	:	915-496-9641

Provider Business Practice Location Address
First Line	:	1221 N COTTON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3015
Country	:	US
Telephone Number	:	915-496-9600
Fax Number	:	915-496-9641

Authorized Official
Title or Position	:	CEO
Name	:	MR. EDUARDO MARTINEZ
Credential	:
Telephone Number	:	91549696000

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	08/22/2020

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