| Project Vida | |
|
3612 Pera Ave. El Paso TX 79905-2412 | |
| (915) 533-7057 | |
| (915) 533-7197 |
| Full Name | Project Vida |
|---|---|
| Speciality | Clinic/Center |
| Location | 3612 Pera Ave., El Paso, Texas |
| Authorized Official Name and Position | William Schlesinger (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9155337057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Project Vida 3607 Rivera Ave. El Paso TX 79905-2415 Ph: (915) 533-7057 | Project Vida 3612 Pera Ave. El Paso TX 79905-2412 Ph: (915) 533-7057 |
| NPI Number | 1184779191 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 11/30/2021 |
| Medicare PECOS PAC ID | 4486614765 |
|---|---|
| Medicare Enrollment ID | O20110204000146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184779191 | NPI | - | NPPES |
| 121004904 | Other | TX | THSTEPS TPI |
| 121004904 | Medicaid | TX | |
| 121004905 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Texas) | Primary |
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