| Camelot Behavioral Health Clinic, Pllc | |
|
1900 Denver Ave El Paso TX 79902-3008 | |
| (915) 544-4000 | |
| (915) 219-9022 |
| Full Name | Camelot Behavioral Health Clinic, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1900 Denver Ave, El Paso, Texas |
| Authorized Official Name and Position | Alfredo Molina (OWNER) |
| Authorized Official Contact | 9152744188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Behavioral Health Clinic, Pllc 3800 N Mesa Suite A2, #201 El Paso TX 79902-1512 Ph: (915) 383-7354 | Camelot Behavioral Health Clinic, Pllc 1900 Denver Ave El Paso TX 79902-3008 Ph: (915) 544-4000 |
| NPI Number | 1720615586 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 05/13/2020 |
| Certification Date | 05/13/2020 |
| Medicare PECOS PAC ID | 7012347669 |
|---|---|
| Medicare Enrollment ID | O20200422000679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720615586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Alfredo M Molina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831316124 PECOS PAC ID: 0345333100 Enrollment ID: I20070910000828 |
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