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NPI Code Detail

MEDICARE: WEST TEXAS OB-GYN, P.A.

MEDICARE: WEST TEXAS OB-GYN, P.A.
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
1207V00000XObstetrics & Gynecology PhysicianG8706TX

General Provider Information

NPI Number : 1306963681
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST TEXAS OB-GYN, P.A.
Provider Business Mailing Address
First Line : 11163 LA QUINTA PLACE
Second Line : SUITE A200
City : EL PASO
State : TX
Zip : 79936-5221
Country : US
Telephone Number : 915-595-1811
Fax Number : 915-595-1980
Provider Business Practice Location Address
First Line : 11163 LA QUINTA PLACE
Second Line : SUITE A200
City : EL PASO
State : TX
Zip : 79936-5221
Country : US
Telephone Number : 915-595-1811
Fax Number : 915-595-1980
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOSE L HERNANDEZ
Credential : M.D.
Telephone Number : 915-595-1811
Provider Enumeration Date : 03/23/2007
Last Update Date : 12/22/2008

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