Organization
WEST TEXAS TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL LEE MARCEL (OWNER/LPC)
(915) 613-0030
Entity
Organization
Contact information
Practice address
1790 N LEE TREVINO DR, #203, EL PASO, TX 79936-4545
(915) 613-0030
(915) 594-7101
Mailing address
1790 N LEE TREVINO DR, #203, EL PASO, TX 79936-4545
(915) 613-0030
(915) 594-7101
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
18932
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B1048075 UPIN
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
10/29/2007
Last updated
10/29/2007
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