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2270 Joe Battle Blvd Ste M El Paso TX 79938-2610 | |
(915) 855-7000 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 2270 Joe Battle Blvd Ste M, El Paso, Texas |
Authorized Official Name and Position | Edgar Reyna (OWNER) |
Authorized Official Contact | 9152461008 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2270 Joe Battle Blvd Ste M El Paso TX 79938-2610 Ph: (915) 855-7000 | 2270 Joe Battle Blvd Ste M El Paso TX 79938-2610 Ph: (915) 855-7000 |
NPI Number | 1992186324 |
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Provider Enumeration Date | 06/11/2015 |
Last Update Date | 06/18/2024 |
Medicare PECOS PAC ID | 4688976301 |
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Medicare Enrollment ID | O20160112001112 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992186324 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | Q4500 (Texas) | Primary |
Provider Name | Edgar D Reyna Maldonado |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215294566 PECOS PAC ID: 7719296813 Enrollment ID: I20151012000381 |
Provider Name | Virginia Gamez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467922930 PECOS PAC ID: 0648697060 Enrollment ID: I20200831003394 |
Provider Name | Magaly Np Diaz |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770262792 PECOS PAC ID: 3274072277 Enrollment ID: I20240821005145 |
Provider Name | Cynthia P Maldonado |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184206054 PECOS PAC ID: 9931648169 Enrollment ID: I20240830003210 |
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