Provider Demographics
NPI:1982696423
Name:WEST TEXAS NEUROSURGICAL CENTER
Entity Type:Organization
Organization Name:WEST TEXAS NEUROSURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-534-2531
Mailing Address - Street 1:2600 N OREGON ST
Mailing Address - Street 2:SUITE800
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3170
Mailing Address - Country:US
Mailing Address - Phone:915-534-2531
Mailing Address - Fax:915-532-2094
Practice Address - Street 1:2600 N OREGON ST
Practice Address - Street 2:SUITE800
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3170
Practice Address - Country:US
Practice Address - Phone:915-534-2531
Practice Address - Fax:915-532-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7903207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX14007147OtherRR/MCR
TXW1945OtherCONSULTEC
TX2997HMOtherBC/BS
TX81438601Medicaid
TXW1945OtherCONSULTEC
TX14007147OtherRR/MCR