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NPI Code Detail

MEDICARE: SALALAU RUTA BLOCKER FNP-C

MEDICARE: SALALAU RUTA BLOCKER FNP-C
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
1363LF0000XFamily Nurse PractitionerAP145678TX

General Provider Information

NPI Number : 1740819382
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALALAU RUTA BLOCKER FNP-C
Provider Business Mailing Address
First Line : 3317 TIERRA ESPADA DR
Second Line :
City : EL PASO
State : TX
Zip : 79938-4739
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12350 PASEO NUEVO DR
Second Line :
City : EL PASO
State : TX
Zip : 79928-5668
Country : US
Telephone Number : 915-225-4470
Fax Number : 915-533-8055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2020
Last Update Date : 11/12/2020

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