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General NPI Number Information
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NPI Number | 1962896340
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Entity Type | Organization
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Legal Business Name | SOUTHWEST HCP ACCESS PA
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 655 E REDD RD STE 201
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City | EL PASO
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State | TX
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Zip | 79912-1242
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Country | US
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Telephone | 915-303-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 4659 COHEN AVE UNIT C
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City | EL PASO
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State | TX
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Zip | 79924-4430
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Country | US
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Telephone | 915-751-1152
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Fax | 915-751-1161
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | JULIE BRAVO
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Credential |
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Telephone | 915-751-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | L4382
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License Number State | TX
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