MEDICARE: JESUS BAEZA OBGYN PLLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1821948803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESUS BAEZA OBGYN PLLC

Provider Business Mailing Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:	--
Fax Number	:

Authorized Official
Title or Position	:	MD OBGYN
Name	:	JESUS BAEZA
Credential	:
Telephone Number	:	--

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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