| Heritage Neurology Pa | |
|
2270 Joe Battle Blvd Ste Q El Paso TX 79938-2610 | |
| (915) 317-1500 | |
| (915) 201-5101 |
| Full Name | Heritage Neurology Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2270 Joe Battle Blvd Ste Q, El Paso, Texas |
| Authorized Official Name and Position | Olajide O Benson (OWNER) |
| Authorized Official Contact | 7135055358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heritage Neurology Pa 4849 N Mesa St Ste 201 El Paso TX 79912-5919 Ph: (915) 351-6600 | Heritage Neurology Pa 2270 Joe Battle Blvd Ste Q El Paso TX 79938-2610 Ph: (915) 317-1500 |
| NPI Number | 1548752041 |
|---|---|
| Provider Enumeration Date | 05/31/2018 |
| Last Update Date | 03/28/2019 |
| Medicare PECOS PAC ID | 0143578807 |
|---|---|
| Medicare Enrollment ID | O20180813001910 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548752041 | NPI | - | NPPES |
| 3883670-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A2900X | Psychiatry & Neurology - Neurocritical Care | Q9956 (Texas) | Primary |
| Provider Name | Olajide O Benson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417191289 PECOS PAC ID: 5597928614 Enrollment ID: I20161025000413 |
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