Provider Demographics
NPI:1194903427
Name:EL PASO THERAPY SERVICES
Entity type:Organization
Organization Name:EL PASO THERAPY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-587-4081
Mailing Address - Street 1:6065 MONTANA AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1837
Mailing Address - Country:US
Mailing Address - Phone:915-225-0519
Mailing Address - Fax:915-225-0523
Practice Address - Street 1:6065 MONTANA AVE STE B2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1837
Practice Address - Country:US
Practice Address - Phone:915-225-0519
Practice Address - Fax:915-225-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0099069332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3823440001OtherMEDICARE ID