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Organization
TEXAS TECH UNIVERSITY EL PASO
Active
Organization
TEXAS TECH UNIVERSITY EL PASO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN M. WAGNER MPA CPAM CCP (MANAGING DIRECTOR)
(915) 783-8164
Entity
Organization
Contact information
Practice address
4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
(915) 545-6785
Mailing address
4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
(408) 569-1445
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
BP10031878
TX
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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