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General NPI Number Information
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NPI Number | 1992067128
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Entity Type | Organization
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Legal Business Name | EL PASO CHILDREN'S PHYSICIAN GROUP
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 5400 ALAMEDA AVE BLDG B
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City | EL PASO
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State | TX
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Zip | 79905-2914
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Country | US
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Telephone | 915-242-8402
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Fax | 915-242-8406
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Provider Business Mailing Address
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Address Line | 5400 ALAMEDA AVE BLDG B
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City | EL PASO
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State | TX
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Zip | 79905-2914
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Country | US
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Telephone | 915-242-8402
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Fax | 915-242-8406
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. LAWRENCE G DUNCAN
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Credential |
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Telephone | 915-242-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) 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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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