MEDICARE: PRO-ACTION, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency	K6973	TX
2	207Q00000X	Family Medicine Physician	K6973	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093853418
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO-ACTION, INC.

Provider Business Mailing Address
First Line	:	PO BOX 962505
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79996-2505
Country	:	US
Telephone Number	:	915-533-3414
Fax Number	:	915-533-3515

Provider Business Practice Location Address
First Line	:	1400 GEORGE DIETER DR STE 260
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7658
Country	:	US
Telephone Number	:	915-533-3414
Fax Number	:	915-533-3515

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. HENRY BRUTUS
Credential	:	MA
Telephone Number	:	915-532-2771

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	06/08/2026

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Directions to “PRO-ACTION, INC. ” Practice Location

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