Provider Demographics
NPI:1326149832
Name:SUNWEST OBGYN ASSOCIATES
Entity Type:Organization
Organization Name:SUNWEST OBGYN ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREDIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-541-1144
Mailing Address - Street 1:7430 REMCON CIR
Mailing Address - Street 2:BLDG B. STE. 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3514
Mailing Address - Country:US
Mailing Address - Phone:915-541-1144
Mailing Address - Fax:915-541-1170
Practice Address - Street 1:7430 REMCON CIR
Practice Address - Street 2:BLDG B. STE. 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3514
Practice Address - Country:US
Practice Address - Phone:915-541-1144
Practice Address - Fax:915-541-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5251174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005544NMedicare ID - Type Unspecified
TXE97707Medicare UPIN