Provider Demographics
NPI:1326051517
Name:CITY OF EL PASO TEXAS
Entity Type:Organization
Organization Name:CITY OF EL PASO TEXAS
Other - Org Name:YSLETA HEALTH CENTER
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:915-212-1092
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 1:110 CANDELARIA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-5506
Practice Address - Country:US
Practice Address - Phone:915-859-7141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251K00000X251K00000X
261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112819102Medicaid