MEDICARE: VMD PRIMARY PROVIDERS OF WEST TEXAS PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	207R00000X	Internal Medicine Physician
3	363A00000X	Physician Assistant
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1619503026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VMD PRIMARY PROVIDERS OF WEST TEXAS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 29472
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-2046
Country	:	US
Telephone Number	:	915-444-5460
Fax Number	:

Provider Business Practice Location Address
First Line	:	10090 RUSHING RD # B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-3803
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR REVENUE CYCLE
Name	:	REBECCA RAGER
Credential	:
Telephone Number	:	844-969-0686

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	03/23/2026

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