| |
4855 N Mesa St Ste 122 El Paso TX 79912-5939 | |
(915) 373-5493 | |
(915) 242-0505 |
Full Name | |
---|---|
Speciality | Counselor |
Location | 4855 N Mesa St Ste 122, El Paso, Texas |
Authorized Official Name and Position | Maria E Paez-rios (PRESIDENT) |
Authorized Official Contact | 9153735493 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4855 N Mesa St Ste 122 El Paso TX 79912-5939 Ph: (915) 373-5493 | 4855 N Mesa St Ste 122 El Paso TX 79912-5939 Ph: (915) 373-5493 |
NPI Number | 1356374722 |
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Provider Enumeration Date | 07/09/2006 |
Last Update Date | 12/03/2024 |
Certification Date | 12/03/2024 |
Medicare PECOS PAC ID | 1052846508 |
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Medicare Enrollment ID | O20241121001087 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356374722 | NPI | - | NPPES |
028664301 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 16679 (Texas) | Primary |
Provider Name | Maria Paez Rios |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1528436805 PECOS PAC ID: 2961937412 Enrollment ID: I20241204001102 |
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