| Luz A. Candelaria,d.o.p.a.,dba/candelaria Medical Center | |
|
8269 North Loop Road El Paso TX 79907-4234 | |
| (915) 591-1615 | |
| (915) 591-2875 |
| Full Name | Luz A. Candelaria,d.o.p.a.,dba/candelaria Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 8269 North Loop Road, El Paso, Texas |
| Authorized Official Name and Position | Luz Alejandro Candelaria (PHYSICIAN, OWNER) |
| Authorized Official Contact | 9155911615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luz A. Candelaria,d.o.p.a.,dba/candelaria Medical Center 8269 North Loop Road El Paso TX 79907-4234 Ph: (915) 591-1615 | Luz A. Candelaria,d.o.p.a.,dba/candelaria Medical Center 8269 North Loop Road El Paso TX 79907-4234 Ph: (915) 591-1615 |
| NPI Number | 1285679936 |
|---|---|
| Provider Enumeration Date | 06/17/2006 |
| Last Update Date | 04/16/2008 |
| Medicare PECOS PAC ID | 2264469402 |
|---|---|
| Medicare Enrollment ID | O20050720000259 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285679936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Blas Alberto Miranda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962577098 PECOS PAC ID: 5193827020 Enrollment ID: I20070223000601 |
| Provider Name | Raul Caudillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619589165 PECOS PAC ID: 2466849005 Enrollment ID: I20220428001541 |
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