Organization
EL PASO INTEGRATED PHYSICIANS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A MORENO MD (PRSIDENT)
(915) 577-0051
Entity
Organization
Contact information
Practice address
8815 DYER ST, SUITE 140, EL PASO, TX 79904-2000
(915) 751-7302
(915) 544-2897
Mailing address
PO BOX 3157, EL PASO, TX 79923-3157
(915) 577-0051
(915) 544-2897
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
363LF0000X
Family Nurse Practitioner
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092550501
—
TX
Enumeration date
03/22/2011
Last updated
03/22/2011
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