Basic Information
| Provider Information | |||||||||
| NPI: | 1689805186 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 ALBERTA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155458826 | ||||||||
| FaxNumber: | 9155456975 | ||||||||
| Practice Location | |||||||||
| Address1: | 4800 ALBERTA AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799052709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155458826 | ||||||||
| FaxNumber: | 9155456975 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2009 | ||||||||
| LastUpdateDate: | 07/31/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHAMARTHI | ||||||||
| AuthorizedOfficialFirstName: | SASTRU | ||||||||
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| AuthorizedOfficialTitleorPosition: | M.D. | ||||||||
| AuthorizedOfficialTelephone: | 9155458826 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC2000X | 390200000X | TX | Y | Hospitals | General Acute Care Hospital | Children |
No ID Information.