MEDICARE: INFECTIOUS DISEASE CENTER OF EL PASO, PA

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	207RI0200X	Infectious Disease Physician	P2341	TX

General Provider Information

NPI Number	:	1699033662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFECTIOUS DISEASE CENTER OF EL PASO, PA

Provider Business Mailing Address
First Line	:	12800 EDGEMERE BLVD STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4693
Country	:	US
Telephone Number	:	915-504-6939
Fax Number	:	915-504-6937

Provider Business Practice Location Address
First Line	:	12800 EDGEMERE BLVD STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4693
Country	:	US
Telephone Number	:	915-504-6939
Fax Number	:	915-504-6937

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD EMEKA PIERI
Credential	:	M.D.
Telephone Number	:	915-504-6939

Provider Enumeration Date	:	04/27/2012
Last Update Date	:	12/08/2025

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