Provider Demographics
NPI:1841383999
Name:ALPHA OMEGA WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:ALPHA OMEGA WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUJA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:915-521-2020
Mailing Address - Street 1:4437 LAZY WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1857
Mailing Address - Country:US
Mailing Address - Phone:915-521-2020
Mailing Address - Fax:915-838-8163
Practice Address - Street 1:2630 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3712
Practice Address - Country:US
Practice Address - Phone:915-521-2020
Practice Address - Fax:915-532-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0040HQOtherBCBS
TXU62655Medicare UPIN
TX0040HQOtherBCBS