Provider Demographics
NPI:1700476843
Name:PRIMARY CARE MEDICAL PARTNERS, PA
Entity Type:Organization
Organization Name:PRIMARY CARE MEDICAL PARTNERS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:YURIRIAN
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-845-7300
Mailing Address - Street 1:1550 N ZARAGOZA RD STE 107
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7905
Mailing Address - Country:US
Mailing Address - Phone:915-845-7300
Mailing Address - Fax:915-207-2143
Practice Address - Street 1:1550 N ZARAGOZA RD STE 107
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7905
Practice Address - Country:US
Practice Address - Phone:915-845-7300
Practice Address - Fax:915-207-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty