Provider Demographics
NPI:1043287287
Name:SALUD Y VIDA, P.A.
Entity Type:Organization
Organization Name:SALUD Y VIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMENDARIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:915-591-2704
Mailing Address - Street 1:1335 GERONIMO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1836
Mailing Address - Country:US
Mailing Address - Phone:915-591-2704
Mailing Address - Fax:915-225-0413
Practice Address - Street 1:6974 GATEWAY BLVD E
Practice Address - Street 2:SUITE F
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1115
Practice Address - Country:US
Practice Address - Phone:915-774-8850
Practice Address - Fax:915-598-3946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2023-08-25
Deactivation Date:2023-08-04
Deactivation Code:
Reactivation Date:2023-08-25
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0924243-03Medicaid
TX0924243-02Medicaid
TX00450KMedicare PIN
TX0924243-02Medicaid