# TEXAS TECH UNIVERSITY EL PASO

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

## Provider details

- **NPI number:** 1447412614
- **Authorized official:** MR. STEVEN M. WAGNER MPA CPAM CCP (MANAGING DIRECTOR)
- **Authorized official phone:** (915) 783-8164

## Contact information

- **Practice address:** 4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
- **Practice address phone:** (915) 545-6785
- **Mailing address:** 4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
- **Mailing address phone:** (408) 569-1445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NC2000X | Children's Hospital | BP10031878 | TX | Yes |

## Other

- **Enumeration date:** 06/30/2008
- **Last updated:** 06/30/2008