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) 545-8823
(915) 545-9799
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-9795
(915) 545-9799
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
TX
2085P0229X
Pediatric Radiology Physician
—
TX
2085R0202X
Diagnostic Radiology Physician
Primary
—
TX
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084602402
—
TX
01
—
CC1842
RAILROAD MEDICARE GROUP #
NM
01
—
G0953
NM MEDICAID GROUP NUMBER
NM
Enumeration date
04/17/2006
Last updated
11/06/2019
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