Organization
TEXAS TECH UNIVERSITY EL PASO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN M. WAGNER MPA CPAM CCP (MANAGING DIRECTOR)
(915) 783-8164
Entity
Organization
Contact information
Practice address
4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
(915) 545-6785
Mailing address
4800 ALBERTA AVE, DEPT OF PEDIATRICS, EL PASO, TX 79905-2709
(408) 569-1445
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
BP10031878
TX
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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