Organization
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO
Active
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
4815 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 521-2291
(915) 521-7873
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6664
(915) 545-9799
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140114328
—
TX
01
—
CC8142
RAILROAD MEDICARE GROUP #
TX
01
—
J77A
MEDICARE
TX
Enumeration date
06/29/2006
Last updated
10/21/2021
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