Provider Demographics
NPI:1063722320
Name:EL PASO INTEGRATED PHYSICIANS GROUP
Entity type:Organization
Organization Name:EL PASO INTEGRATED PHYSICIANS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-577-0051
Mailing Address - Street 1:1810 MURCHISON DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2930
Mailing Address - Country:US
Mailing Address - Phone:915-544-0326
Mailing Address - Fax:915-544-2897
Practice Address - Street 1:1810 MURCHISON DR
Practice Address - Street 2:SUITE 300
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2930
Practice Address - Country:US
Practice Address - Phone:915-544-0326
Practice Address - Fax:915-544-2897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7903207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty