NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center

  • Surgery Physician
  • El Paso, TX
National Provider Identifier
1083167134
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Practice address
2000 B Transmountain Road
El Paso, TX 79911
Phone
(915) 215-5626
Fax
(915) 545-6984
NPI assigned
Jul 25, 2016
Last updated
Jul 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Authorized official

Name
Mr. Steven Marc Wagner, PH.D. M.P.A.
Title
Managing Director
Phone
(915) 215-4478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2000 B Transmountain Road
El Paso, TX 79911

Mailing address

4800 Alberta Ave
101
El Paso, TX 79905
Phone (915) 215-4478

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000806 TX Part B Supplier - Clinic/Group Practice 7517864754 Receives reassigned benefits from 864 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Paso, TX; Alpine, TX

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
TX Tech Univ HLTH Scien27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1083167134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 ALBERTA AVE",
            "address_2": "101",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79905",
            "telephone_number": "915-215-4478",
            "fax_number": "915-545-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 B TRANSMOUNTAIN ROAD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79911",
            "telephone_number": "915-215-5626",
            "fax_number": "915-545-6984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-25",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "915-215-4478",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PH.D. M.P.A."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "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 Jul 25, 2016; 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.