Provider Demographics
NPI:1861665713
Name:SOUTHWEST CENTER FOR REPRODUCTIVE HEALTH, P.A.
Entity Type:Organization
Organization Name:SOUTHWEST CENTER FOR REPRODUCTIVE HEALTH, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-842-9998
Mailing Address - Street 1:700 S MESA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5504
Mailing Address - Country:US
Mailing Address - Phone:915-842-9998
Mailing Address - Fax:915-842-9972
Practice Address - Street 1:700 S MESA HILLS DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5504
Practice Address - Country:US
Practice Address - Phone:915-842-9998
Practice Address - Fax:915-842-9972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4394174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0018CVOtherBC/BS TX
NM00NM00YH89OtherBC/BS NM
NM00NM00YH89OtherBC/BS NM