| El Paso Infectious Diseases, Pa | |
|
1250 E Cliff Dr Ste 5f El Paso TX 79902-4850 | |
| (915) 400-2600 | |
| (915) 591-9215 |
| Full Name | El Paso Infectious Diseases, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1250 E Cliff Dr Ste 5f, El Paso, Texas |
| Authorized Official Name and Position | Jacquelyn Ann Gouveia (PHYSICIAN - OWNER) |
| Authorized Official Contact | 9154002600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| El Paso Infectious Diseases, Pa 1250 E Cliff Dr Ste 5f El Paso TX 79902-4850 Ph: (915) 400-2600 | El Paso Infectious Diseases, Pa 1250 E Cliff Dr Ste 5f El Paso TX 79902-4850 Ph: (915) 400-2600 |
| NPI Number | 1437571114 |
|---|---|
| Provider Enumeration Date | 01/14/2014 |
| Last Update Date | 09/17/2019 |
| Medicare PECOS PAC ID | 7719110097 |
|---|---|
| Medicare Enrollment ID | O20140513000787 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437571114 | NPI | - | NPPES |
| M8004 | Other | TX | TX MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | M8004 (Texas) | Primary |
| Provider Name | Jacquelyn A Gouveia |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669534699 PECOS PAC ID: 2567403751 Enrollment ID: I20080213000080 |
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