1689806234 NPI number — EL PASO ASC LP

Table of content: (NPI 1689806234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689806234 NPI number — EL PASO ASC LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EL PASO ASC LP
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:
ENDOSCOPY CENTER OF EL PASO
Provider Other Organization Name Type Code:
3
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:
1689806234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 MURCHISON DR
Provider Second Line Business Mailing Address:
SUITE 180
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79902-4842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-544-5000
Provider Business Mailing Address Fax Number:
915-544-5001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 MURCHISON DR
Provider Second Line Business Practice Location Address:
SUITE 180
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79902-4842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-544-5000
Provider Business Practice Location Address Fax Number:
915-544-5001
Provider Enumeration Date:
08/17/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CLENDENIN
Authorized Official First Name:
PHILLIP
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
615-665-1283

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8F33697 . This is a "CRNA DUANE RIEGEL" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L20195 . This is a "CRNA PATRICK HANDY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8F33696 . This is a "CRNA RIC BARIBEAULT" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L23364 . This is a "CRNA DARLENE MILLER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8F33695 . This is a "CRNA LAURA GARCIA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L23970 . This is a "CRNA ROTH OWEN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L25450 . This is a "CRNA GLYNN COOPER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L22433 . This is a "CRNA JAMES BODOH" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L22432 . This is a "CRNA JAMES MATTINGLY" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L21090 . This is a "CRNA JASON GALES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L219066 . This is a "CRNA JOEL EHLER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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