Provider Demographics
NPI:1124240437
Name:FIRST CHOICE OBGYN ASSOCIATES PA
Entity type:Organization
Organization Name:FIRST CHOICE OBGYN ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:NOVOA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:915-351-0907
Mailing Address - Street 1:310 N. MESA
Mailing Address - Street 2:SUITE 520
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1301
Mailing Address - Country:US
Mailing Address - Phone:915-351-0907
Mailing Address - Fax:
Practice Address - Street 1:5140 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4904
Practice Address - Country:US
Practice Address - Phone:915-772-2713
Practice Address - Fax:915-772-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04255363A00000X
TX697757363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX040148103Medicaid
TX0039JYOtherBCBS
TX0039JYOtherBCBS
TX040148103Medicaid