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5005 N Piedras St El Paso TX 79920-5001 | |
| (915) 569-2400 | |
| (915) 569-1960 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 5005 N Piedras St, El Paso, Texas |
| Authorized Official Name and Position | Jessica Kleberg (SVP OF LEGAL AND COMPLIANCE) |
| Authorized Official Contact | 7046642876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
655 Brawley School Rd Ste 200 Mooresville NC 28117-9601 Ph: (704) 664-2876 | 5005 N Piedras St El Paso TX 79920-5001 Ph: (915) 569-2400 |
| NPI Number | 1760571962 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 11/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760571962 | NPI | - | NPPES |
| 001003376 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K6689 (Texas) | Primary |
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