Healthcare Provider Details

I. General information

NPI: 1225104292
Provider Name (Legal Business Name): CITY OF EL PASO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 09/02/2025
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 PERA AVE
EL PASO TX
79905-2313
US

IV. Provider business mailing address

5115 EL PASO DR STE B
EL PASO TX
79905-2818
US

V. Phone/Fax

Practice location:
  • Phone: 915-212-8000
  • Fax: 915-212-0413
Mailing address:
  • Phone: 915-212-7895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number14305
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CORTINAS
Title or Position: CFO
Credential:
Phone: 915-212-1067