Healthcare Provider Details

I. General information

NPI: 1639085657
Provider Name (Legal Business Name): UMC EL PASO HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 CIMARRON RIALTO PLACE
EL PASO TX
79912
US

IV. Provider business mailing address

1770 CIMARRON RIALTO PLACE
EL PASO TX
79912
US

V. Phone/Fax

Practice location:
  • Phone: 915-833-2969
  • Fax:
Mailing address:
  • Phone: 915-833-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number
License Number State

VIII. Authorized Official

Name: ADRIANA VILLAGRANA
Title or Position: PRACTICE MANAGER
Credential:
Phone: 915-996-4240