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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
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
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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