Provider Demographics
NPI:1376752733
Name:CLARENCE PITRE MD PA
Entity Type:Organization
Organization Name:CLARENCE PITRE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-629-8888
Mailing Address - Street 1:10201 GATEWAY WEST
Mailing Address - Street 2:STE 401
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925
Mailing Address - Country:US
Mailing Address - Phone:915-692-8888
Mailing Address - Fax:
Practice Address - Street 1:10201 GATEWAY WEST
Practice Address - Street 2:STE 401
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:905-629-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00296FOtherMEDICARE PROVIDER NO