Provider Demographics
NPI:1366864191
Name:CITY OF EL PASO TEXAS
Entity Type:Organization
Organization Name:CITY OF EL PASO TEXAS
Other - Org Name:DEPT. OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-771-5779
Mailing Address - Street 1:5115 EL PASO DRIVE
Mailing Address - Street 2:SUITE B, CLINIC A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2818
Mailing Address - Country:US
Mailing Address - Phone:915-771-5779
Mailing Address - Fax:915-771-5893
Practice Address - Street 1:5115 EL PASO DRIVE
Practice Address - Street 2:SUITE B, CLINIC A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2818
Practice Address - Country:US
Practice Address - Phone:915-771-5779
Practice Address - Fax:915-771-5893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare