Your Image Boutique Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

YOUR IMAGE BOUTIQUE INC

Practice address

3401 Montana Ave
El Paso, TX 79903-4330

Phone

(915) 564-5923

Fax

(915) 565-1310

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth Lorraine Martinez, CMF

Title

President/Owner

Phone

(915) 564-5923

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366675200000",
    "number": "1922105899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034330",
            "telephone_number": "915-564-5923",
            "fax_number": "915-565-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 MONTANA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034330",
            "telephone_number": "915-564-5923",
            "fax_number": "915-565-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR IMAGE BOUTIQUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-04-23",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "915-564-5923",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMF"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010688201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Young Men's Christian Association of Greater El Paso TX and Rio Grande
• Chen Hua Young, NP
• Lisa Young, M.ED, LPC
• Maya An Young
• Sean Young, DDS
• Your Infinity Health LLC
• Your Life Chiropractic Injury Clinic, LLC
• Your Next Step TX LCSW PLLC
• Mina Youssef, MD
• Taim Youssef I

• Prosthetic/Orthotic Supplier in El Paso, TX
• Providers in El Paso, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.