Provencio Enterprises Incorporated

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PROVENCIO ENTERPRISES INCORPORATED

Practice address

5380 N Mesa St Ste 108
El Paso, TX 79912-5869

Phone

(915) 613-3989

Fax

(915) 503-2737

NPI assigned

Oct 2, 2018

Organization subpart

No

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

Authorized official

Name

Griselda P OaxacaNPI 1578051256

Title

Owner/Director

Phone

(915) 613-3989

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Griselda P Oaxaca

  • Developmental Therapist
  • El Paso, TX
  • NPI 1578051256

  Single Specialty

  NPD (past) Authorized official

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538438400000",
    "number": "1790260107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5380 N MESA ST STE 108",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125869",
            "telephone_number": "915-613-3989",
            "fax_number": "915-503-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5380 N MESA ST STE 108",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125869",
            "telephone_number": "915-613-3989",
            "fax_number": "915-503-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVENCIO ENTERPRISES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A",
        "authorized_official_last_name": "OAXACA",
        "authorized_official_first_name": "GRISELDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "915-613-3989"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Maria Prospero Ponce
• Justina A Prospero
• Scott Alan Protzman, M.D.
• Provedoras Caseras de El Paso Inc.
• Proveedoras de Luz Home Health, LLC
• Provencio Enterprises Incorporated
• Mauro Provencio, M.D.
• Tracy Lynn Provenghi, DDS
• Providence Imaging Consultants, P.a.
• Providence Service Corporation

• Clinic/Center in El Paso, TX
• Providers in El Paso, TX by specialty
• Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.