Healthcare Provider Details

I. General information

NPI: 1356404321
Provider Name (Legal Business Name): VAZCO PULMONARY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N OREGON ST STE 610
EL PASO TX
79902-3366
US

IV. Provider business mailing address

PO BOX 10309
EL PASO TX
79995-0309
US

V. Phone/Fax

Practice location:
  • Phone: 915-532-2477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171R00000X
TaxonomyInterpreter
License NumberE5454
License Number StateTX

VIII. Authorized Official

Name: DR. GENARO VAZQUEZ
Title or Position: MEDICAL DOCTOR
Credential: MD
Phone: 915-532-2477