Provider Demographics
NPI:1366427130
Name:EL PASO SPECIALTY HOSPITAL LTD
Entity type:Organization
Organization Name:EL PASO SPECIALTY HOSPITAL LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-544-3636
Mailing Address - Street 1:1755 CURIE DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2919
Mailing Address - Country:US
Mailing Address - Phone:915-544-3636
Mailing Address - Fax:915-544-6114
Practice Address - Street 1:1755 CURIE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2919
Practice Address - Country:US
Practice Address - Phone:915-544-3636
Practice Address - Fax:915-544-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007282282N00000X
TX282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1483224-01Medicaid
TXHH1001OtherBLUE CROSS PROVIDER NUMBE
TX1483224-02Medicaid
TX1483224-02Medicaid
TX450845Medicare Oscar/Certification