Provider Demographics
NPI:1891235370
Name:TRANSMOUNTAIN PRIMARY CARE, PA
Entity Type:Organization
Organization Name:TRANSMOUNTAIN PRIMARY CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-248-2345
Mailing Address - Street 1:13001 EASTLAKE BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-6312
Mailing Address - Country:US
Mailing Address - Phone:152-482-3459
Mailing Address - Fax:866-726-3556
Practice Address - Street 1:13001 EASTLAKE BLVD STE 105
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-6312
Practice Address - Country:US
Practice Address - Phone:915-248-2345
Practice Address - Fax:915-271-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-02
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty