Healthcare Provider Details

I. General information

NPI: 1568464550
Provider Name (Legal Business Name): EL PASO PULMONARY ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 N MESA ST STE A
EL PASO TX
79902-1105
US

IV. Provider business mailing address

4305 N MESA ST STE A
EL PASO TX
79902-1105
US

V. Phone/Fax

Practice location:
  • Phone: 915-532-2477
  • Fax: 915-532-2470
Mailing address:
  • Phone: 915-532-2477
  • Fax: 915-532-2470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. EUGENIO ARMENDARIZ
Title or Position: PRESIDENT
Credential: MD
Phone: 915-532-2477