MEDICARE: ROBERTO R OCHOA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	L4084	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8W0189	OTHER	TX	BCBS
2	P00399357	OTHER	TX	RAILROAD

General Provider Information

NPI Number	:	1255320214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO R OCHOA MD

Provider Business Mailing Address
First Line	:	5412 SOLEDAD LN
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-2029
Country	:	US
Telephone Number	:	915-833-5528
Fax Number	:	915-521-7920

Provider Business Practice Location Address
First Line	:	5412 SOLEDAD LN
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-2029
Country	:	US
Telephone Number	:	915-833-5528
Fax Number	:	915-521-7920

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	12/14/2007

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