Provider Demographics
NPI:1235142423
Name:CITY OF EL PASO TEXAS
Entity Type:Organization
Organization Name:CITY OF EL PASO TEXAS
Other - Org Name:CITY OF EL PASO DEPARTMENT OF PUBLIC HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-212-1067
Mailing Address - Street 1:5115 EL PASO DR STE A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2818
Mailing Address - Country:US
Mailing Address - Phone:915-212-6512
Mailing Address - Fax:915-212-0168
Practice Address - Street 1:5115 EL PASO DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2818
Practice Address - Country:US
Practice Address - Phone:915-212-6609
Practice Address - Fax:915-212-0172
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF EL PASO TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-15
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX065086301Medicaid
TX120978503Medicaid
TX00N19AMedicare PIN