# INJURY MEDICAL CLINIC PA

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

## Provider details

- **NPI number:** 1972794147
- **Authorized official:** DR. ALEXANDER DAVID JIMENEZ DC (PRESIDENT/CHIROPRACTOR)
- **Authorized official phone:** (915) 412-6677

## Contact information

- **Practice address:** 11860 VISTA DEL SOL DR \# 128, EL PASO, TX 79936-6128
- **Practice address phone:** (915) 413-6677
- **Practice address fax:** (866) 574-1351
- **Mailing address:** 11860 VISTA DEL SOL DR \# 128, EL PASO, TX 79936-6128
- **Mailing address phone:** (915) 413-6677
- **Mailing address fax:** (866) 574-1351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 305R00000X | Preferred Provider Organization | DC5807 | TX | — |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 02/17/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 8C0040 | BCBS PROVIDER \# | TX |