Organization Active NPI

El Paso Center for Family & Sports Medicine PA

  • Sports Medicine (Family Medicine) Physician
  • El Paso, TX
National Provider Identifier
1063777019
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
N9857 Issued in TX
Legal business name
EL PASO CENTER FOR FAMILY & SPORTS MEDICINE PA
Practice address
1600 N Lee Trevino Dr
Suite D3
El Paso, TX 79936-5169
Phone
(915) 493-6646
NPI assigned
Jul 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Authorized official

Name
Angel Joel Garcia, MDNPI 1801058177
Title
Owner/Director
Phone
(915) 449-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X N9857 TX Primary

Addresses

Primary practice location

1600 N Lee Trevino Dr
Suite D3
El Paso, TX 79936-5169

Mailing address

5959 Gateway Blvd W Ste 120
El Paso, TX 79925-3315
Phone (915) 779-1716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120927000507 TX Part B Supplier - Clinic/Group Practice 5193974640 Receives reassigned benefits from 2 practitioners
Practice locations: El Paso, TX
O20141119000576 TX DME Supplier - Physician - Family Practice 5193974640 Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

11851 Physicians Dr
El Paso, TX 79936
Phone (915) 221-0326

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347840000000",
    "number": "1063777019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 GATEWAY BLVD W STE 120",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253315",
            "telephone_number": "915-779-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 N LEE TREVINO DR",
            "address_2": "SUITE D3",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365169",
            "telephone_number": "915-493-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO CENTER FOR FAMILY & SPORTS MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-09-17",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "915-449-7200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "N9857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.