Organization
EL PASO COLON AND RECTAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHRISTINE GOMEZ (OFFICE MANAGER)
(915) 544-4042
Entity
Organization
Contact information
Practice address
900 CHELSEA ST, EL PASO, TX 79903-4927
(915) 544-4042
(915) 857-7809
Mailing address
4849 N MESA ST STE 201, EL PASO, TX 79912-5919
(915) 351-6600
(915) 351-6601
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H9957
TX
208600000X
Surgery Physician
N6538
TX
208C00000X
Colon & Rectal Surgery Physician
H9957
TX
208C00000X
Colon & Rectal Surgery Physician
N6538
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84633301
—
TX
Enumeration date
10/18/2006
Last updated
12/27/2018
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