| El Paso Primary Healthcare Physicians, P.a. | |
|
11880 Vista Del Sol Dr El Paso TX 79936-6128 | |
| (915) 855-7900 | |
| (915) 855-7755 |
| Full Name | El Paso Primary Healthcare Physicians, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 11880 Vista Del Sol Dr, El Paso, Texas |
| Authorized Official Name and Position | Olmer R Brooker (PRESIDENT) |
| Authorized Official Contact | 9158557900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Paso Primary Healthcare Physicians, P.a. 11880 Vista Del Sol Dr El Paso TX 79936-6128 Ph: (915) 855-7900 | El Paso Primary Healthcare Physicians, P.a. 11880 Vista Del Sol Dr El Paso TX 79936-6128 Ph: (915) 855-7900 |
| NPI Number | 1639120892 |
|---|---|
| Provider Enumeration Date | 05/13/2006 |
| Last Update Date | 06/18/2013 |
| Medicare PECOS PAC ID | 6406873553 |
|---|---|
| Medicare Enrollment ID | O20051027000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639120892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | E5012 (Texas) | Primary |
| Provider Name | Ronald F Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427052042 PECOS PAC ID: 0749174639 Enrollment ID: I20040211000838 |
| Provider Name | Raul Zayas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942252549 PECOS PAC ID: 7113998840 Enrollment ID: I20040804001670 |
| Provider Name | Ralu Hinojos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992801294 PECOS PAC ID: 6406815331 Enrollment ID: I20041006001313 |
| Provider Name | Olmer Brooker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952304297 PECOS PAC ID: 0446161657 Enrollment ID: I20051027000827 |
| Provider Name | Jaime Holberton Square |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205046752 PECOS PAC ID: 4587754270 Enrollment ID: I20071218000556 |
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