HOSPITALIST GROUP OF EL PASO PA

Provider Demographics

• NPI: 1023068590
• Name: HOSPITALIST GROUP OF EL PASO PA
• Entity type: Organization
• Organization Name: HOSPITALIST GROUP OF EL PASO PA
• Authorized Official - Title/Position: PRESIDENT
• Authorized Official - First Name: CLAY
• Authorized Official - Middle Name: M
• Authorized Official - Last Name: HEIGHTEN
• Authorized Official - Credentials: MD
• Authorized Official - Phone: 972-739-3001
• Mailing Address - Street 1: 1626 MEDICAL CTR STE 503
• Mailing Address - Street 2: 5TH FLOOR
• Mailing Address - City: EL PASO
• Mailing Address - State: TX
• Mailing Address - Zip Code: 79902-5015
• Mailing Address - Country: US
• Mailing Address - Phone: 915-546-9200
• Practice Address - Street 1: 1626 MEDICAL CTR STE 503
• Practice Address - Street 2: 5TH FLOOR
• Practice Address - City: EL PASO
• Practice Address - State: TX
• Practice Address - Zip Code: 79902-5015
• Practice Address - Country: US
• Practice Address - Phone: 915-546-9200
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2006-05-12
• Last Update Date: 2008-06-10

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207R00000X	Allopathic & Osteopathic Physicians	Internal Medicine		Group - Multi-Specialty
No	207Q00000X	Allopathic & Osteopathic Physicians	Family Medicine		Group - Multi-Specialty
No	207RG0300X	Allopathic & Osteopathic Physicians	Internal Medicine	Geriatric Medicine	Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NM	23707348	Medicaid
TX	158220702	Medicaid
TX	158220701	Medicaid
TX	0040KK	Other	BCBS
TX	158220703	Medicaid
NM	23707348	Medicaid
TX	00193V	Medicare PIN
TX	158220702	Medicaid
TX	158220701	Medicaid