Organization
CENTRO SAN VICENTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA ILENE PAZ (CEO)
(915) 859-7545
Entity
Organization
Contact information
Practice address
1208 MYRTLE AVE, EL PASO, TX 79901-1602
(915) 351-8972
Mailing address
1208 MYRTLE AVE, EL PASO, TX 79901-1602
(915) 351-8972
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130880107
—
TX
Enumeration date
07/25/2007
Last updated
05/06/2026
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