Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO
Active
Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO
Active
Other names
Texas Tech University Health Sciences Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUE FUCIARELLI (VICE PRESIDENT FOR FINANCE AND ADMI)
(915) 215-4300
Entity
Organization
Contact information
Practice address
4801 ALBERTA AVE., 230C, EL PASO, TX 79905
(915) 545-6664
(915) 545-9799
Mailing address
4801 ALBERTA AVE., 230C, EL PASO, TX 79905
(915) 545-6664
(915) 545-9799
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
TX
207XS0106X
Orthopaedic Hand Surgery Physician
—
TX
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
TX
213E00000X
Podiatrist
—
TX
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084600801
—
TX
01
—
CC8142
RAILROAD MEDICARE GROUP #
TX
Enumeration date
03/24/2006
Last updated
11/06/2019
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