Provider Demographics
NPI:1710324884
Name:SCOTT BLUMENFELD MD PLLC
Entity Type:Organization
Organization Name:SCOTT BLUMENFELD MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUMENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-204-6691
Mailing Address - Street 1:PO BOX 220122
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79913-2122
Mailing Address - Country:US
Mailing Address - Phone:915-833-3500
Mailing Address - Fax:
Practice Address - Street 1:10501 GATEWAY BLVD W
Practice Address - Street 2:SUITE140
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7934
Practice Address - Country:US
Practice Address - Phone:915-544-7300
Practice Address - Fax:915-833-3509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH79082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty