| Dwayne Friday, M.d., Pllc | |
|
811 Chelsea St Ste A El Paso TX 79903-4925 | |
| (915) 259-1390 | |
| (888) 824-5635 |
| Full Name | Dwayne Friday, M.d., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 811 Chelsea St Ste A, El Paso, Texas |
| Authorized Official Name and Position | Zelda Thomas (ADMINISTRATOR) |
| Authorized Official Contact | 9152591390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dwayne Friday, M.d., Pllc 811 Chelsea St Ste A El Paso TX 79903-4925 Ph: (915) 259-1390 | Dwayne Friday, M.d., Pllc 811 Chelsea St Ste A El Paso TX 79903-4925 Ph: (915) 259-1390 |
| NPI Number | 1619490133 |
|---|---|
| Provider Enumeration Date | 07/18/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 6002180171 |
|---|---|
| Medicare Enrollment ID | O20170928001216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619490133 | NPI | - | NPPES |
| 298202701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | P3150 (Texas) | Primary |
| Provider Name | Dwayne Eldrich Friday |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619101557 PECOS PAC ID: 9739343989 Enrollment ID: I20120619000571 |
| Provider Name | Paola Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770142507 PECOS PAC ID: 5092102418 Enrollment ID: I20220503000955 |
| Provider Name | Rosa Emma Marquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194592659 PECOS PAC ID: 3173974953 Enrollment ID: I20240105000868 |
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