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General NPI Number Information
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NPI Number | 1194231845
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Entity Type | Organization
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Legal Business Name | BEN LEYVA, PA
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 1393 GEORGE DIETER DR STE E
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City | EL PASO
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State | TX
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Zip | 79936-7410
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Country | US
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Telephone | 915-228-4915
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Fax | 915-975-8007
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Provider Business Mailing Address
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Address Line | 4849 N MESA ST STE 201
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City | EL PASO
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State | TX
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Zip | 79912-5919
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Country | US
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Telephone | 915-351-6600
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Fax | 915-351-6601
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN LEYVA
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Credential | D.C.
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Telephone | 512-705-1581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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