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NPI Code Detail

MEDICARE: EL PASO PSYCHIATRIC ASSOCIATES PA

MEDICARE: EL PASO PSYCHIATRIC ASSOCIATES PA
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
1261QM0850XAdult Mental Health Clinic/Center875-ATX
2261QM0855XAdolescent and Children Mental Health Clinic/Center875-ATX
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center875-ATX
4261QM0850XAdult Mental Health Clinic/Center
5261QM0855XAdolescent and Children Mental Health Clinic/Center
6261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
7261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HH5066OTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3HH6759OTHERTXBLUE CROSS BLUE SHIELD OF

General Provider Information

NPI Number : 1700937869
Entity Type Code : Organization
Provider Name (Legal Business Name) : EL PASO PSYCHIATRIC ASSOCIATES PA
Provider Business Mailing Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Provider Business Practice Location Address
First Line : 7760 ALABAMA ST
Second Line :
City : EL PASO
State : TX
Zip : 79904-3136
Country : US
Telephone Number : 915-757-7999
Fax Number : 915-757-8004
Authorized Official
Title or Position : CEO
Name : MRS. CAROL J ANDERSON-JIMENEZ
Credential : PHD, PMHNP-BC
Telephone Number : 915-757-7999
Provider Enumeration Date : 01/16/2007
Last Update Date : 03/23/2015

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