Organization
EL PASO FAMILY MEDICINE AND MENTAL HEALTH CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTAN L BANNISTER APRN (PRESIDENT)
(915) 289-2100
Entity
Organization
Contact information
Practice address
8929 VISCOUNT BLVD STE LLB, EL PASO, TX 79925-5827
(915) 289-2100
(915) 289-2104
Mailing address
8929 VISCOUNT BLVD STE LLB, EL PASO, TX 79925-5827
(915) 289-2100
(915) 289-2104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
364SP0813X
Geropsychiatric Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Enumeration date
05/24/2024
Last updated
06/24/2024
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