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General NPI Number Information
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NPI Number | 1417958901
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Entity Type | Organization
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Legal Business Name | LA CLINICA GUADALUPANA, INC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 ASCENCION ST
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City | EL PASO
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State | TX
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Zip | 79928-9080
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Country | US
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Telephone | 915-852-3328
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Fax | 915-852-4246
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Provider Business Mailing Address
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Address Line | 901 ASCENCION ST
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City | EL PASO
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State | TX
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Zip | 79928-9080
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Country | US
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Telephone | 915-852-3328
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Fax | 915-852-4246
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. MARGARET RENEE DENEWETH
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Credential | RN
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Telephone | 915-526-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | TX
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