Provider Demographics
NPI:1881218667
Name:CREP CHIROPRACTIC SERVICES
Entity Type:Organization
Organization Name:CREP CHIROPRACTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-244-6801
Mailing Address - Street 1:1393 GEORGE DIETER DR STE E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7410
Mailing Address - Country:US
Mailing Address - Phone:915-228-4915
Mailing Address - Fax:915-975-8007
Practice Address - Street 1:1393 GEORGE DIETER DR STE E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7410
Practice Address - Country:US
Practice Address - Phone:915-228-4915
Practice Address - Fax:915-975-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty