Healthcare Provider Details

I. General information

NPI: 1558659714
Provider Name (Legal Business Name): EL PASO CHILDREN'S HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 04/01/2024
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

V. Phone/Fax

Practice location:
  • Phone: 915-298-5444
  • Fax:
Mailing address:
  • Phone: 915-298-5444
  • Fax: 915-242-8610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number100133
License Number StateTX

VIII. Authorized Official

Name: CINDY ANN STOUT
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 915-242-8600