YOUR IMAGE BOUTIQUE INC (NPI# 1922105899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922105899 |
| Entity Type | Organization |
| Organization Name | YOUR IMAGE BOUTIQUE INC |
| Practice Address |
3401 Montana Ave El Paso TX 79903-4330 |
| Practice Telephone | 9155645923 |
| Practice Fax Number | 9155651310 |
| Mailing Telephone | 9155645923 |
| Mailing Fax Number | 9155651310 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-04-23 |
| Authorized Official Name | MS. ELIZABETH LORRAINE MARTINEZ (PRESIDENT/OWNER) |
| Authorized Official Telephone | 9155645923 |
| Authorized Official Credential | CMF |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 010688201 | 05 |
| Street Address |
3401 MONTANA AVE |
| City | EL PASO |
| State | TX |
| Zip Code | 79903-4330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447757562 | Jacqueline J. Pantoja | Behavior Technician | 4100 Cumberland Ave, El Paso, TX 79903 | 2018-04-06 |
| 1891207718 | Luna Tierra Casa De Partos | Midwife | 4130 Hueco Ave., El Paso, TX 79903 | 2017-11-01 |
| 1275982415 | James Blanco I | Counselor | 6000 Welch #15, El Paso, TX 79903 | 2016-06-08 |
| 1902269426 | Mayra Gaona | Contractor | 3431 Pershing Dr. Ste D1, El Paso, TX 79903 | 2016-04-01 |
| 1164777918 | Silvia Elena Marrufo | Chiropractor | 2601 E Yandell Dr Ste 223, El Paso, TX 79903 | 2012-07-18 |
| 1992062335 | Claudia Marie Yagel | Occupational Therapist | 2429 Montanna Ave, #a, El Paso, TX 79903 | 2012-04-23 |
| 1801164199 | Kavita Bhakta | Pharmacist | 2879 Montana, El Paso, TX 79903 | 2011-12-01 |
| 1396032074 | Oscar Arteaga | Community/Behavioral Health | 4664 Caples Cir, El Paso, TX 79903 | 2011-07-01 |
| 1487977716 | William Beaumont Army Medical Center-army Substance Abuse Program | Social Worker | 1512 Mathias, El Paso, TX 79903 | 2010-03-01 |
| 1841434008 | Sun City Behavioral Health Care | Counselor | 2931 Montana Ave., Suite B, El Paso, TX 79903 | 2009-04-30 |
| Find all providers in zip 79903 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891019485 | Jenny Miriam Aguilar | Prosthetic/Orthotic Supplier | 10600 Rayito Pl, El Paso, TX 79924-1916 | 2010-03-25 |
| 1366585689 | Precision Prosthetic Inc | Prosthetic/Orthotic Supplier | 1501 Missouri Ave, El Paso, TX 79902 | 2007-02-15 |
| 1255417929 | Custom Orthotics & Prosthetics, Lp | Prosthetic/Orthotic Supplier | 3901 Montana Ave Ste C, El Paso, TX 79903-4507 | 2006-10-27 |
| 1417063660 | International Limb & Brace Inc | Prosthetic/Orthotic Supplier | 3727 Montana Ave, El Paso, TX 79903-4503 | 2006-08-21 |
| 1992232789 | El Paso Prosthetic Center, LLC | Prosthetic/Orthotic Supplier | 1800 N Mesa St, Suite 100, El Paso, TX 79902-3553 | 2017-05-11 |
| 1548653181 | Neu Limbs, LLC | Prosthetic/Orthotic Supplier | 2260 Trawood Dr, El Paso, TX 79935-3040 | 2015-03-06 |
| 1649560780 | El Paso Professional Rehabilitation Pllc | Prosthetic/Orthotic Supplier | 2044 Trawood Dr, El Paso, TX 79935-3503 | 2011-04-11 |
| 1447551601 | Platinum Innovations, Ltd. | Prosthetic/Orthotic Supplier | 2039 Trawood Dr, Ste B, El Paso, TX 79935-3501 | 2010-11-04 |
| 1326379736 | Total Orthotic & Prosthetic Solutions, Inc. | Prosthetic/Orthotic Supplier | 1393 George Dieter Dr, Suite C, El Paso, TX 79936-7410 | 2010-01-25 |
| 1053546036 | Louis E. Zuniga Pt PC | Prosthetic/Orthotic Supplier | 4646 N Mesa St, Suite B, El Paso, TX 79912-6104 | 2009-05-20 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.