# MISSION VALLEY MEDICAL CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053624932
- **Authorized official:** AIDA R DE LA VEGA (PRESIDENT)
- **Authorized official phone:** (915) 820-9228

## Contact information

- **Practice address:** 9001 CASHEW DR, STE 900, EL PASO, TX 79907-2967
- **Practice address phone:** (915) 858-2300
- **Practice address fax:** (915) 858-2302
- **Mailing address:** 9001 CASHEW DR, STE 900, EL PASO, TX 79907-2967
- **Mailing address phone:** (915) 820-9228
- **Mailing address fax:** (305) 388-4380

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/20/2010
- **Last updated:** 05/20/2011