Provider Demographics
NPI:1689002156
Name:EL PASO WELLNESS ASSOCIATES
Entity type:Organization
Organization Name:EL PASO WELLNESS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:915-440-0060
Mailing Address - Street 1:1600 N LEE TREVINO DR STE A2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-5164
Mailing Address - Country:US
Mailing Address - Phone:915-440-0060
Mailing Address - Fax:915-440-0081
Practice Address - Street 1:1600 N LEE TREVINO DR STE A2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5164
Practice Address - Country:US
Practice Address - Phone:915-440-0060
Practice Address - Fax:915-440-0081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX686449363LF0000X
363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty