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NEW LIGHT PRIMARY CARE P. A NPI 1508183385


NPI Information

NPI: 1508183385
Provider Name: NEW LIGHT PRIMARY CARE P. A

Other Name: NEW LIGHT PRIMARY CARE PA

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 45D2017174

Address:
3615 RUTHERGLEN ST
EL PASO, TX
ZIP 79925
Phone: (915) 772-5400
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NEW LIGHT PRIMARY CARE P. A is a family medicine in El Paso, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. NEW LIGHT PRIMARY CARE P. A NPI is 1508183385. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is New Light Primary Care Pa.

The provider's business location address is:

3615 RUTHERGLEN ST
EL PASO, TX
ZIP 79925-416
Phone: (915) 772-5400
Fax: (915) 772-5402

The provider's authorized official is Martha Manquero-butler .
The authorized official title is President and has the following contact phone number (915) 772-5400.

The CLIA number assigned to this NPI record is 45D2017174 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2010 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1TXB104258MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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