# PROJECT VIDA

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

## Provider details

- **NPI number:** 1952634602
- **Authorized official:** DR. RODRIGO CEBALLOS M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (512) 589-5519

## Contact information

- **Practice address:** 3612 PERA AVE, EL PASO, TX 79905-2412
- **Practice address phone:** (915) 533-7057
- **Practice address fax:** (915) 533-7158
- **Mailing address:** 3612 PERA AVE, EL PASO, TX 79905-2412
- **Mailing address phone:** (915) 533-7057
- **Mailing address fax:** (915) 533-7158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 678490 | TX | Yes |

## Other

- **Enumeration date:** 09/14/2009
- **Last updated:** 09/14/2009