Provider Demographics
NPI:1639606247
Name:OSCAR VEGA JR
Entity Type:Organization
Organization Name:OSCAR VEGA JR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:915-533-5606
Mailing Address - Street 1:5959 GATEWAY BLVD W STE 120
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3315
Mailing Address - Country:US
Mailing Address - Phone:915-779-1716
Mailing Address - Fax:
Practice Address - Street 1:1700 N OREGON ST
Practice Address - Street 2:SUITE 500
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3584
Practice Address - Country:US
Practice Address - Phone:915-533-5606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3880207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty