Provider Demographics
NPI:1932469012
Name:JGGPO CORPORATION
Entity Type:Organization
Organization Name:JGGPO CORPORATION
Other - Org Name:EL PASO PULMONARY REHABILITATION INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, RT
Authorized Official - Phone:915-566-7584
Mailing Address - Street 1:7806 GATEWAY BLVD E STE 100
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1806
Mailing Address - Country:US
Mailing Address - Phone:915-566-7584
Mailing Address - Fax:915-566-7682
Practice Address - Street 1:4994 HONDO PASS DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-7022
Practice Address - Country:US
Practice Address - Phone:915-566-7584
Practice Address - Fax:915-566-7682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800442031261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)