Organization · NPI-2

Injury Medical Clinic PA

General Practice · El Paso, TX

NPI number1972794147
StatusActive
Last updated in NPPESFeb 17, 2022

Details

NPI
1972794147
Entity type
Organization (NPI-2)
Legal business name
Injury Medical Clinic PA
Organization subpart
No
Enumeration date
Aug 5, 2007
Certification date
Feb 17, 2022
Last updated
Feb 17, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208D00000X General Practice––Yes
305R00000X Preferred Provider OrganizationDC5807TX

Practice location

11860 Vista Del Sol Dr # 128
El Paso, TX 79936-6128

Phone 915-413-6677 · Fax 866-574-1351

Mailing address

11860 Vista Del Sol Dr # 128
El Paso, TX 79936-6128

Phone 915-413-6677 · Fax 866-574-1351

Authorized official

Alexander David Jimenez
President/Chiropractor
9154126677

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