MEDICARE: TRANSMOUNTAIN PRIMARY CARE, PA

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	207Q00000X	Family Medicine Physician		TX

General Provider Information

NPI Number	:	1891235370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSMOUNTAIN PRIMARY CARE, PA

Provider Business Mailing Address
First Line	:	12373 KNIGHTSBRIDGE DR
Second Line	:
City	:	HORIZON CITY
State	:	TX
Zip	:	79928-3706
Country	:	US
Telephone Number	:	915-248-2345
Fax Number	:	866-726-3556

Provider Business Practice Location Address
First Line	:	500 PEYTON HILLS DR STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79928-4448
Country	:	US
Telephone Number	:	915-248-2345
Fax Number	:	866-726-3556

Authorized Official
Title or Position	:	OWNER/ PHYSICIAN
Name	:	DR. JOSE A MARIN
Credential	:	MD
Telephone Number	:	915-248-2345

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	04/10/2026

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