| Workers Pain Management Center, Pllc | |
|
11880 Vista Del Sol Dr Ste B El Paso TX 79936-6128 | |
| (915) 777-3151 | |
| (915) 855-6111 |
| Full Name | Workers Pain Management Center, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11880 Vista Del Sol Dr Ste B, El Paso, Texas |
| Authorized Official Name and Position | Jaime Holberton Square (PRESIDENT) |
| Authorized Official Contact | 9157773151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Workers Pain Management Center, Pllc Po Box 961783 El Paso TX 79996-1783 Ph: (915) 777-3151 | Workers Pain Management Center, Pllc 11880 Vista Del Sol Dr Ste B El Paso TX 79936-6128 Ph: (915) 777-3151 |
| NPI Number | 1518264670 |
|---|---|
| Provider Enumeration Date | 02/24/2011 |
| Last Update Date | 09/14/2023 |
| Medicare PECOS PAC ID | 6507036431 |
|---|---|
| Medicare Enrollment ID | O20110831000527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518264670 | NPI | - | NPPES |
| 290386601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M7650 (Texas) | Primary |
| Provider Name | Jaime Holberton Square |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205046752 PECOS PAC ID: 4587754270 Enrollment ID: I20071218000556 |
| Provider Name | Laura G Lightner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114429974 PECOS PAC ID: 2264765577 Enrollment ID: I20190531000102 |
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