Healthcare Provider Details

I. General information

NPI: 1720304900
Provider Name (Legal Business Name): VETERANS AFFAIRS-EL PASO, TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 N PIEDRAS ST
EL PASO TX
79930-4210
US

IV. Provider business mailing address

1330 E ORGAN AVE
LAS CRUCES NM
88001-2914
US

V. Phone/Fax

Practice location:
  • Phone: 915-564-6400
  • Fax:
Mailing address:
  • Phone: 575-520-0887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QV0200X
TaxonomyVA Clinic/Center
License NumberM-07165
License Number StateNM

VIII. Authorized Official

Name: CRYSTAL MARIE TAPIA
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 575-520-0887