Organization
TEXAS TECH PHYSICIAN ASSOCIATES AT EL PASO
Active
Other names
Texas Tech UHSC Ophthalmology
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN M. WAGNER (MANAGING DIRECTOR)
(915) 783-8164
Entity
Organization
Contact information
Practice address
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 783-8185
(915) 783-8187
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 781-8164
(915) 783-8187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192487001
—
TX
Enumeration date
05/14/2007
Last updated
07/23/2008
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