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General NPI Number Information
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NPI Number | 1811168438
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Entity Type | Organization
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Legal Business Name | SOUTHWEST ORTHOPEDIC TECHNOLOGISTS
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Dates
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Enumeration Date | 03/23/2008
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Last Update Date | 03/23/2008
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Provider Practice Location Address
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Address Line | 1051 MILL VALLEY RD
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City | EL PASO
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State | TX
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Zip | 79927-4881
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Country | US
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Telephone | 915-820-8857
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Fax |
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Provider Business Mailing Address
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Address Line | 1051 MILL VALLEY RD
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City | EL PASO
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State | TX
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Zip | 79927-4881
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Country | US
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Telephone | 915-820-8857
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Fax |
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Authorized Official
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Title or Position | ORTHOPEDIC TECHNOLOGIST CERTIFIED
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Name | MR. ALEJANDRO LUIS BECERRA
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Credential | O.T.C.
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Telephone | 915-820-8857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 05-1113
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License Number State | TX
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