| El Paso Center For Family & Sports Medicine Pa | |
|
1600 N Lee Trevino Dr Suite D3 El Paso TX 79936-5169 | |
| (915) 493-6646 | |
| Not Available |
| Full Name | El Paso Center For Family & Sports Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1600 N Lee Trevino Dr, El Paso, Texas |
| Authorized Official Name and Position | Angel Joel Garcia (OWNER/DIRECTOR) |
| Authorized Official Contact | 9154497200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Paso Center For Family & Sports Medicine Pa 5959 Gateway Blvd W Ste 120 El Paso TX 79925-3315 Ph: (915) 779-1716 | El Paso Center For Family & Sports Medicine Pa 1600 N Lee Trevino Dr Suite D3 El Paso TX 79936-5169 Ph: (915) 493-6646 |
| NPI Number | 1063777019 |
|---|---|
| Provider Enumeration Date | 07/05/2012 |
| Last Update Date | 09/17/2012 |
| Medicare PECOS PAC ID | 5193974640 |
|---|---|
| Medicare Enrollment ID | O20120927000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063777019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | N9857 (Texas) | Primary |
| Provider Name | Angel J Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801058177 PECOS PAC ID: 9436308988 Enrollment ID: I20120927000557 |
| Provider Name | Amanda M Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770047474 PECOS PAC ID: 5799015822 Enrollment ID: I20210811000139 |
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