Provider Demographics
NPI:1962702837
Name:EL PASO URGENT CARE CENTER
Entity type:Organization
Organization Name:EL PASO URGENT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:915-588-5443
Mailing Address - Street 1:10501 GATEWAY BLVD W
Mailing Address - Street 2:SUITE 105
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10501 GATEWAY BLVD W
Practice Address - Street 2:SUITE 105
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7929
Practice Address - Country:US
Practice Address - Phone:915-588-5443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care