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Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN M. WAGNER (MANAGING DIRECTOR)
(915) 783-8164
Entity
Organization
Contact information
Practice address
9849 KENWORTHY ST, EL PASO, TX 79924-4402
(915) 757-3178
(915) 783-8187
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 783-8164
(915) 783-8187
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140114318
—
TX
Enumeration date
11/14/2008
Last updated
11/14/2008
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