Healthcare Provider Details

I. General information

NPI: 1093412835
Provider Name (Legal Business Name): CISCO HOMES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11395 JAMES WATT DR STE A11
EL PASO TX
79936-5946
US

IV. Provider business mailing address

11395 JAMES WATT DR STE A11
EL PASO TX
79936-5946
US

V. Phone/Fax

Practice location:
  • Phone: 915-588-0337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: FRANCISCO ARROYOS III
Title or Position: PRESIDENT
Credential:
Phone: 915-588-0337