Provider Demographics
NPI:1831500677
Name:EL PASO DEDICATED SERVICES
Entity Type:Organization
Organization Name:EL PASO DEDICATED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:DIAZ-OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-412-2036
Mailing Address - Street 1:5124 LA TASTE AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79924-4631
Mailing Address - Country:US
Mailing Address - Phone:915-803-4241
Mailing Address - Fax:915-600-5776
Practice Address - Street 1:5124 LA TASTE AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4631
Practice Address - Country:US
Practice Address - Phone:915-803-4241
Practice Address - Fax:915-600-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care