Healthcare Provider Details

I. General information

NPI: 1326051517
Provider Name (Legal Business Name): CITY OF EL PASO TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CANDELARIA ST
EL PASO TX
79907-5506
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 915-859-7141
  • Fax:
Mailing address:
  • Phone: 915-212-6512
  • Fax: 915-212-0168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number251K00000X
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CORTINAS
Title or Position: CFO
Credential:
Phone: 915-212-1092