Provider Demographics
NPI:1871082107
Name:EL PASO PULMONARY ASSOCIATION
Entity type:Organization
Organization Name:EL PASO PULMONARY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ISABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALVERDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-242-6396
Mailing Address - Street 1:4305 N MESA ST STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1124
Mailing Address - Country:US
Mailing Address - Phone:575-339-1080
Mailing Address - Fax:
Practice Address - Street 1:2465 S TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5049
Practice Address - Country:US
Practice Address - Phone:575-339-1080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty