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
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 545-7507
(915) 545-7569
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6664
(915) 783-8187
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
TX
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084583601
—
TX
01
—
140114302
CSHCN GROUP NUMBER
TX
01
—
CC8142
RAILROAD MEDICARE GROUP #
TX
Enumeration date
10/18/2006
Last updated
05/29/2024
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