Healthcare Provider Details

I. General information

NPI: 1730363425
Provider Name (Legal Business Name): VALERIE JEAN DAHILL PAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N MESA ST SUITE 200
EL PASO TX
79902-3553
US

IV. Provider business mailing address

506 CROWN POINT DR
EL PASO TX
79912-4830
US

V. Phone/Fax

Practice location:
  • Phone: 915-577-9900
  • Fax: 915-577-0200
Mailing address:
  • Phone: 915-252-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA05566
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: