Provider Demographics
NPI:1306963681
Name:WEST TEXAS OB-GYN, P.A.
Entity type:Organization
Organization Name:WEST TEXAS OB-GYN, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-595-1811
Mailing Address - Street 1:11163 LA QUINTA PLACE
Mailing Address - Street 2:SUITE A200
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-5221
Mailing Address - Country:US
Mailing Address - Phone:915-595-1811
Mailing Address - Fax:915-595-1980
Practice Address - Street 1:11163 LA QUINTA PLACE
Practice Address - Street 2:SUITE A200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5221
Practice Address - Country:US
Practice Address - Phone:915-595-1811
Practice Address - Fax:915-595-1980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8706207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty