| El Paso Medical Group Pa | |
|
550 S Mesa Hills Dr Ste C2 El Paso TX 79912-5765 | |
| (915) 532-6069 | |
| (915) 532-5060 |
| Full Name | El Paso Medical Group Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 S Mesa Hills Dr Ste C2, El Paso, Texas |
| Authorized Official Name and Position | Douglas Payne (OWNER/PRESIDENT) |
| Authorized Official Contact | 9155326069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Paso Medical Group Pa 550 S Mesa Hills Dr Ste C2 El Paso TX 79912-5765 Ph: (915) 532-6069 | El Paso Medical Group Pa 550 S Mesa Hills Dr Ste C2 El Paso TX 79912-5765 Ph: (915) 532-6069 |
| NPI Number | 1306168133 |
|---|---|
| Provider Enumeration Date | 02/21/2010 |
| Last Update Date | 04/08/2024 |
| Medicare PECOS PAC ID | 7719019934 |
|---|---|
| Medicare Enrollment ID | O20100722000807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306168133 | NPI | - | NPPES |
| TXB104323 | Other | TX | PTAN |
| N1054 | Other | TX | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Douglas B Payne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487639183 PECOS PAC ID: 0648374074 Enrollment ID: I20100722000834 |
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