1417960600 NPI number — EL PASO CITY COUNTY HEALTH AND ENVIRONMENTAL DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417960600 NPI number — EL PASO CITY COUNTY HEALTH AND ENVIRONMENTAL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EL PASO CITY COUNTY HEALTH AND ENVIRONMENTAL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
YSLETA HEALTH CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417960600
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5115 EL PASO DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79905-2818
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-771-5741
Provider Business Mailing Address Fax Number:
915-771-5893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 CANDELARIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79907-5506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-859-7141
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MAGANA
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
915-771-5702

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  251K00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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