MEDICARE: EL PASO INTEGRATED PHYSICIANS GROUP

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	31375	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
2	2168444	OTHER		PK

General Provider Information

NPI Number	:	1528505708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL PASO INTEGRATED PHYSICIANS GROUP

Provider Business Mailing Address
First Line	:	4532 N MESA STREET STE 1A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912
Country	:	US
Telephone Number	:	915-703-6302
Fax Number	:	877-415-8557

Provider Business Practice Location Address
First Line	:	4532 N MESA ST STE 1A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-6286
Country	:	US
Telephone Number	:	915-703-6302
Fax Number	:	877-415-8557

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	PAUL GALBIATI
Credential	:
Telephone Number	:	915-532-2400

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	09/19/2025

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