Centro San Vicente | |
10780 Pebble Hills Blvd Ste G1 El Paso TX 79935-2034 | |
(915) 859-7545 | |
(915) 859-9862 |
Full Name | Centro San Vicente |
---|---|
Speciality | Clinic/Center |
Location | 10780 Pebble Hills Blvd, El Paso, Texas |
Authorized Official Name and Position | Jose Luna (CEO) |
Authorized Official Contact | 9158597545 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Centro San Vicente 8061 Alameda Ave El Paso TX 79915-4705 Ph: (915) 859-7545 | Centro San Vicente 10780 Pebble Hills Blvd Ste G1 El Paso TX 79935-2034 Ph: (915) 859-7545 |
NPI Number | 1215473707 |
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Provider Enumeration Date | 01/09/2017 |
Last Update Date | 03/21/2017 |
Medicare PECOS PAC ID | 1355330994 |
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Medicare Enrollment ID | O20170323000611 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215473707 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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