Provider Demographics
NPI:1427367796
Name:EL PASO CENTER FOR WOMEN'S HEALTH P.A.
Entity Type:Organization
Organization Name:EL PASO CENTER FOR WOMEN'S HEALTH P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:RANDALL
Authorized Official - Last Name:GORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-503-1804
Mailing Address - Street 1:910 E REDD RD
Mailing Address - Street 2:SUITE K #333
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7359
Mailing Address - Country:US
Mailing Address - Phone:915-503-1804
Mailing Address - Fax:915-503-1806
Practice Address - Street 1:1800 N MESA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3553
Practice Address - Country:US
Practice Address - Phone:915-503-1804
Practice Address - Fax:915-503-1806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3666207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty