SUN CITY SPORTS MEDICINE AND FAMILY CLINIC, PA
Osteopathic Medicine at Joe Battle Blvd, El Paso, TX

License number
Texas P1809
Category
Osteopathic Medicine
Type
Sports Medicine
Owner
Name: MAURO PROVENCIO
Title: MD/OWNER
Phone: (915) 525-3209
Address
Address
3270 Joe Battle Blvd SUITE 150, El Paso, TX 79938
National Provider ID: 1114289956
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SUN CITY SPORTS MEDICINE AND FAMILY CLINIC, PA at bizstanding.com

SUN CITY SPORTS MEDICINE AND FAMILY CLINIC, PA

El Paso, TX

Status:
Inactive
Registration:
May 15, 2012
Addresses:
3270 Joe Battle Blvd STE 150, El Paso, TX 79938 (Mailing)
100 N Stanton St, El Paso, TX 79901
State ID:
0801597318
Business type:
Professional Association
Director, Member:
Mauro Provencio Director, Member, inactive
TIN:
32047968311

Osteopathic Medicine licenses in Texas










Other Doctors licenses in Texas