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Organization
TEXAS FEDERAL WELLNESS CENTER OF EL PASO, PLLC
Active
Organization
TEXAS FEDERAL WELLNESS CENTER OF EL PASO, PLLC
Active
Other names
Texas Federal Wellness Center of El Paso
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE ZIMMER (CREDENTIALING SPECIALIST)
(512) 800-3659
Entity
Organization
Contact information
Practice address
12185 NEW WORLD DR, EL PASO, TX 79936-6396
(915) 303-8121
(915) 303-8180
Mailing address
12185 NEW WORLD DR, EL PASO, TX 79936-6396
(915) 303-8121
(915) 303-8180
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
NULL
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
2251X0800X
Orthopedic Physical Therapist
—
NULL
2251X0800X
Orthopedic Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
02/28/2019
Last updated
02/28/2019
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