NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center

  • Family Medicine Physician
  • El Paso, TX
National Provider Identifier
1437364536
Registry record updated Nov 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Practice address
9849 Kenworthy St
El Paso, TX 79924-4402
Phone
(915) 757-2581
Fax
(915) 545-9799
NPI assigned
May 11, 2007
Last updated
Nov 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2008

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

Authorized official

Name
Steven M. Wagner
Title
Managing Director
Phone
(915) 545-6664

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X NU
Family Medicine Physician 207Q00000X NU Primary
Adult Medicine Physician 207QA0505X NU

Addresses

Primary practice location

9849 Kenworthy St
El Paso, TX 79924-4402

Mailing address

PO Box 9520
El Paso, TX 79995-9520
Phone (915) 545-6664

Other identifiers 1

IdentifierTypeStateIssuer
084597601MedicaidTX

Other names 1

  • Texa Tech UHSC Family Medicine Other name

National Provider Directory

National Provider Directory
Tax ID family
Texa Tech Uhsc Family Medicine13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1437364536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9520",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799959520",
            "telephone_number": "915-545-6664",
            "fax_number": "915-545-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9849 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244402",
            "telephone_number": "915-757-2581",
            "fax_number": "915-545-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "915-545-6664"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084597601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texa Tech UHSC Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 4, 2008; 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.