Provider Demographics
NPI:1710105069
Name:V HELENA VADI LATIFF MD PA
Entity Type:Organization
Organization Name:V HELENA VADI LATIFF MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:V HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:VADI LATIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-774-5514
Mailing Address - Street 1:5959 GATEWAY WEST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3315
Mailing Address - Country:US
Mailing Address - Phone:915-774-5514
Mailing Address - Fax:915-779-1754
Practice Address - Street 1:5959 GATEWAY WEST
Practice Address - Street 2:SUITE 120
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3315
Practice Address - Country:US
Practice Address - Phone:915-774-5514
Practice Address - Fax:915-779-1754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6382207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00389TMedicare ID - Type Unspecified