Organization
WEST TEXAS PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON D PENDERGRAS (PRESIDENT)
(915) 581-6644
Entity
Organization
Contact information
Practice address
200 BARTLETT DR, SUITE 108, EL PASO, TX 79912-1628
(915) 581-7960
(915) 584-7599
Mailing address
200 BARTLETT DR, SUITE 108, EL PASO, TX 79912-1628
(915) 581-7960
(915) 584-7599
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
33BP3500X
TX
Other
Enumeration date
05/03/2006
Last updated
04/17/2008
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