Healthcare Provider Details

I. General information

NPI: 1982973988
Provider Name (Legal Business Name): HILLVIEW NIGHT CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL CENTER DR SUITE 410
EL PASO TX
79902-5002
US

IV. Provider business mailing address

1600 MEDICAL CENTER DR SUITE 410
EL PASO TX
79902-5002
US

V. Phone/Fax

Practice location:
  • Phone: 915-532-1466
  • Fax:
Mailing address:
  • Phone: 915-532-1466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberJ0889
License Number StateTX

VIII. Authorized Official

Name: DR. JESUS L LOZANO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 915-532-1466