Organization
EL PASO CARDIAC VASCULAR & THORACIC SURGEONS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS HUMBERTO CORRAL MD (PRESIDENT)
(915) 542-0400
Entity
Organization
Contact information
Practice address
1700 N OREGON ST, STE 750, EL PASO, TX 79902-3584
(915) 542-0400
(915) 542-1188
Mailing address
1700 N OREGON ST, STE 750, EL PASO, TX 79902-3584
(915) 542-0400
(915) 542-1188
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000X3247
SALUD PROGRAMS MEDICAID
NM
01
—
0049AU
BCBS
TX
Enumeration date
11/17/2005
Last updated
08/22/2020
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