MEDICARE: EL PASO WEST EMERGENCY ROOM LLC

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1689026114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL PASO WEST EMERGENCY ROOM LLC

Provider Business Mailing Address
First Line	:	351 E REDD ROAD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-0000
Country	:	US
Telephone Number	:	214-443-8131
Fax Number	:	214-443-8392

Provider Business Practice Location Address
First Line	:	351 E REDD ROAD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-0000
Country	:	US
Telephone Number	:	214-443-8131
Fax Number	:	214-443-8392

Authorized Official
Title or Position	:	CHIEF OPERATIONS OFFICER
Name	:	MR. JUAN CARLOS SALDIVAR
Credential	:
Telephone Number	:	281-900-4033

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	04/08/2025

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