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Organization

TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO

Active
Other names
Texas Tech Univeristy HSC/Ob/Gyn
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
4801 ALBERTA AVE., EL PASO, TX 79905
(915) 545-9795
(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
207SG0201X
Clinical Genetics (M.D.) Physician
207V00000X
Obstetrics & Gynecology Physician
Primary
207VC0200X
Critical Care Medicine (Obstetrics & Gynecology) Physician
207VE0102X
Reproductive Endocrinology Physician
207VM0101X
Maternal & Fetal Medicine Physician
207VX0000X
Obstetrics Physician
207VX0201X
Gynecologic Oncology Physician
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
084598401
TX
01
140114307
GROUP CSHCN NUMBER
TX
Enumeration date
09/01/2006
Last updated
04/18/2022
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