Organization
WEST TEXAS CHILDRENS CANCER & BLOOD DISORDERS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ABIGAIL DOMINGUEZ (OFFICE MANAGER)
(915) 541-8903
Entity
Organization
Contact information
Practice address
125 W HAGUE, STE 500, EL PASO, TX 79902
(915) 541-8903
(915) 313-0125
Mailing address
125 W HAGUE, STE 500, EL PASO, TX 79902
(915) 541-8903
(915) 313-0125
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
J0881
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12555305
IND MCD
TX
05
—
70187
—
NM
Enumeration date
09/07/2006
Last updated
08/22/2020
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