Provider Demographics
NPI:1447028485
Name:COTTONWOOD NEPHROLOGY AND HYPERTENSION CENTER LLC
Entity type:Organization
Organization Name:COTTONWOOD NEPHROLOGY AND HYPERTENSION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TOSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OPAWUMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-591-2922
Mailing Address - Street 1:10201 GATEWAY BLVD W STE 210
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7647
Mailing Address - Country:US
Mailing Address - Phone:915-595-2286
Mailing Address - Fax:
Practice Address - Street 1:3830 E LOHMAN AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8446
Practice Address - Country:US
Practice Address - Phone:915-731-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty