NPI Code Details Logo

NPI 1407719982

NPI 1407719982 : HAROLD P. RADCLIFF : EL PASO, TX

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1407719982
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    HAROLD P. RADCLIFF
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/03/2025
-----------------------------------------------------
    Last Update Date     |    12/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    106 MESA PARK DR STE 200 
-----------------------------------------------------
    City                 |    EL PASO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79912-6122
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    915-300-3484
-----------------------------------------------------
    Fax                  |    866-531-7508
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    106 MESA PARK DR STE 200 
-----------------------------------------------------
    City                 |    EL PASO
-----------------------------------------------------
    State                |    TX
-----------------------------------------------------
    Zip                  |    79912-6122
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    915-300-3484
-----------------------------------------------------
    Fax                  |    866-531-7508
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    1213321
-----------------------------------------------------
    License Number State |    TX
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.