Organization
PEDIATRIC GROUP OF CENTRAL EL PASO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTURO CASILLAS M.D. (OWNER/PHYSICIAN)
(915) 577-0444
Entity
Organization
Contact information
Practice address
1400 N EL PASO ST, BLDG. E, EL PASO, TX 79902-3437
(915) 577-0444
Mailing address
5959 GATEWAY BLVD W, STE. 120, EL PASO, TX 79925-3331
(915) 779-1716
(915) 779-1754
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U70B
BCBS
TX
05
—
085741901
—
TX
Enumeration date
07/09/2006
Last updated
05/17/2011
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