Provider Demographics
NPI:1124816152
Name:1550 ZARAGOZA RD PLLC
Entity type:Organization
Organization Name:1550 ZARAGOZA RD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CASIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-626-6118
Mailing Address - Street 1:10510 MONTWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-2717
Mailing Address - Country:US
Mailing Address - Phone:915-219-4713
Mailing Address - Fax:915-206-5880
Practice Address - Street 1:1550 N ZARAGOZA RD STE A101
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7905
Practice Address - Country:US
Practice Address - Phone:915-490-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental