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Organization

YSLETA DEL SUR PUEBLO COMMUNITY HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN LOPEZ (HHS DIRECTOR)
(915) 858-1076
Entity
Organization

Contact information

Practice address
9473 SOCORRO RD, EL PASO, TX 79907
(915) 860-6113
(915) 860-6166
Mailing address
9473 SOCORRO RD, EL PASO, TX 79907-5619
(915) 858-1076
(915) 860-6166

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
17718
TX
261Q00000X
Clinic/Center
261QP0904X
Federal Public Health Clinic/Center
Primary
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
1603-1603A
TX
343800000X
Secured Medical Transport (VAN)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
092524001
TX
05
4480063-01
TX
Enumeration date
11/08/2006
Last updated
11/20/2024
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