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General NPI Number Information
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NPI Number | 1649059700
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Entity Type | Organization
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Legal Business Name | PALLIATIVE COALITION PLLC
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 2121 WYOMING AVE
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City | EL PASO
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State | TX
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Zip | 79903-3508
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Country | US
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Telephone | 915-307-4669
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Fax |
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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 |
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Authorized Official
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Title or Position | OWNER
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Name | JOSE BURGOS
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Credential |
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Telephone | 915-307-4669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family 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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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