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Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Active
Other names
Texas Tech Health Sciences Center Community Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN M. WAGNER (MANAGING DIRECTOR)
(915) 545-6664
Entity
Organization
Contact information
Practice address
313 S RIO VISTA RD, EL PASO, TX 79927-1646
(915) 859-0817
(915) 858-3278
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6664
(915) 545-9799
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC8142
RAILROAD MEDICARE GROUP #
TX
Enumeration date
05/01/2006
Last updated
11/13/2007
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