NPIMap

Organization Active NPI

El Paso Primary Healthcare Physician

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1811048085
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E5012 Issued in TX
Legal business name
EL PASO PRIMARY HEALTHCARE PHYSICIAN
Practice address
1418 George Dieter Dr
Suite B
El Paso, TX 79936-7601
Phone
(915) 855-7900
Fax
(915) 855-7755
NPI assigned
Jan 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Veronica Trillo
Title
Office Manager
Phone
(915) 855-7900

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X L5234 TX
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X J2933 TX
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X E5012 TX Primary

Addresses

Primary practice location

1418 George Dieter Dr
Suite B
El Paso, TX 79936-7601

Mailing address

1418 George Dieter Dr
Suite B
El Paso, TX 79936-7601
Phone (915) 855-7900

Other names 1

  • Physicians Healthcare Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
El Paso Primary Healthcare Physician2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1418 George Dieter Dr
Ste B
El Paso, TX 79936
Phone (915) 544-2455

Practitioners & affiliated clinicians

Practitioners 4

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": "1168819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1811048085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 GEORGE DIETER DR",
            "address_2": "SUITE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367601",
            "telephone_number": "915-855-7900",
            "fax_number": "915-855-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 GEORGE DIETER DR",
            "address_2": "SUITE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367601",
            "telephone_number": "915-855-7900",
            "fax_number": "915-855-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO PRIMARY HEALTHCARE PHYSICIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "TRILLO",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "915-855-7900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L5234",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J2933",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E5012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Healthcare Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 20, 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.