MEDICARE: EDUARDO DANIEL ROSAS BLUM M.D.

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	2080P0206X	Pediatric Gastroenterology Physician	N4046	TX
2	208000000X	Pediatrics Physician	N4046	TX
3	208000000X	Pediatrics Physician	MD 2009-0066	NM

General Provider Information

NPI Number	:	1316133218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDUARDO DANIEL ROSAS BLUM M.D.

Provider Business Mailing Address
First Line	:	1351 N ZARAGOZA RD BLDG J-1
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7902
Country	:	US
Telephone Number	:	915-615-7005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1351 N ZARAGOZA RD BLDG J-1
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-7902
Country	:	US
Telephone Number	:	915-615-7005
Fax Number	:

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

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	05/01/2026

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