# AMANECER PSYCHOLOGICAL SERVICES

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

## Provider details

- **NPI number:** 1356435903
- **Authorized official:** DR. RODOLFO BASURTO PHD (PRESIDENT)
- **Authorized official phone:** (915) 779-5600

## Contact information

- **Practice address:** 6044 GATEWAY EAST, SUITE 405, EL PASO, TX 79905
- **Practice address phone:** (915) 779-5600
- **Practice address fax:** (915) 779-5605
- **Mailing address:** 6044 GATEWAY EAST, SUITE 405, EL PASO, TX 79905
- **Mailing address phone:** (915) 779-5600
- **Mailing address fax:** (915) 779-5605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0046HQ | BCBS OF TEXAS | TX |
| 01 | — | NM600035 | NM MEDICAID | NM |