Provider Demographics
NPI:1659622538
Name:EPIPG MHT PLLC
Entity Type:Organization
Organization Name:EPIPG MHT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-577-0051
Mailing Address - Street 1:1810 MURCHISON DR
Mailing Address - Street 2:STE 300
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2930
Mailing Address - Country:US
Mailing Address - Phone:915-577-0051
Mailing Address - Fax:915-577-0054
Practice Address - Street 1:1810 MURCHISON DR
Practice Address - Street 2:STE 300
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2930
Practice Address - Country:US
Practice Address - Phone:915-577-0051
Practice Address - Fax:915-577-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7470207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty