| Methadone | |
|
1900 Wyoming Ave El Paso TX 79903-3409 | |
| (915) 779-3764 | |
| (915) 775-0283 |
| Full Name | Methadone |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1900 Wyoming Ave, El Paso, Texas |
| Authorized Official Name and Position | Ivonne Tapia (CEO) |
| Authorized Official Contact | 9157824000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Methadone Po Box 371710 El Paso TX 79937-1710 Ph: (915) 775-4638 | Methadone 1900 Wyoming Ave El Paso TX 79903-3409 Ph: (915) 779-3764 |
| NPI Number | 1396067716 |
|---|---|
| Provider Enumeration Date | 02/26/2010 |
| Last Update Date | 12/15/2020 |
| Certification Date | 12/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396067716 | NPI | - | NPPES |
| 212223601 | Medicaid | TX | |
| 402A | Other | TX | DSHS LICENSE NUMBER |
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