1144596727 NPI number — FAMILY MEDICINE OF WEST TEXAS PLLC

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 1144596727 NPI number — FAMILY MEDICINE OF WEST TEXAS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY MEDICINE OF WEST TEXAS PLLC
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:
Provider Other Organization Name Type Code:
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:
1144596727
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4445 N MESA ST STE 122
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:
79902-1117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-219-4300
Provider Business Mailing Address Fax Number:
915-519-4300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7236 N MESA 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:
79912-3653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-581-6405
Provider Business Practice Location Address Fax Number:
915-581-6409
Provider Enumeration Date:
03/28/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MUNOZ
Authorized Official First Name:
XAVIER
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
915-581-6405

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  L5477 , 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)

  • Identifier: L5477 . This is a "TX DRIVERS LICENSE # MUNOZ 14055431" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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