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General NPI Number Information
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NPI Number | 1578379517
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Entity Type | Organization
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Legal Business Name | VILLA PAIN INSTITUTE PLLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1351 N ZARAGOZA RD BLDG R
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City | EL PASO
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State | TX
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Zip | 79936-7902
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Country | US
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Telephone | 833-339-7246
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Fax | 915-257-6302
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Provider Business Mailing Address
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Address Line | 6955 N MESA ST STE 200
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City | EL PASO
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State | TX
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Zip | 79912-4442
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Country | US
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Telephone | 833-339-7246
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Fax | 915-257-6302
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | ROSEMARY DE LA CRUZ
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Credential | MD
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Telephone | 978-701-1754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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