Provider Demographics
NPI:1003263799
Name:2OVE1 LLC
Entity Type:Organization
Organization Name:2OVE1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HARRE
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:915-474-9779
Mailing Address - Street 1:3116 TIERRA PAOLA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4311
Mailing Address - Country:US
Mailing Address - Phone:915-222-0472
Mailing Address - Fax:
Practice Address - Street 1:4620 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4708
Practice Address - Country:US
Practice Address - Phone:915-222-0472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-23
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare