Green Mountain Healthcare Services LLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

GREEN MOUNTAIN HEALTHCARE SERVICES LLC

Practice address

2311 N Mesa St Ste H
El Paso, TX 79902-3575

Phone

(915) 500-4883

Fax

(915) 275-5510

NPI assigned

Jul 19, 2022

Last updated

Jul 19, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Roberto Flores

Title

Administrator/Owner

Phone

(915) 276-0865

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1053046623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 N MESA ST STE H",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023575",
            "telephone_number": "915-500-4883",
            "fax_number": "915-275-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 N MESA ST STE H",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023575",
            "telephone_number": "915-500-4883",
            "fax_number": "915-275-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "915-276-0865"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Geriatric Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.