Healthcare Provider Details

I. General information

NPI: 1861523235
Provider Name (Legal Business Name): RGTG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 12/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 S FESTIVAL DR
EL PASO TX
79912-5801
US

IV. Provider business mailing address

109 S FESTIVAL DR
EL PASO TX
79912-5801
US

V. Phone/Fax

Practice location:
  • Phone: 915-842-1788
  • Fax: 915-842-1778
Mailing address:
  • Phone: 915-842-1788
  • Fax: 915-842-1778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. HECTOR ZAVALETA
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CFO
Phone: 915-842-1788