MEDICARE: MS. SANDRA NAVARRO 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	390200000X	Student in an Organized Health Care Education/Training Program	BP10034677	TX
2	207Q00000X	Family Medicine Physician	P4088	TX

General Provider Information

NPI Number	:	1952545188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA NAVARRO M.D.

Provider Business Mailing Address
First Line	:	4815 ALAMEDA AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79905-2705
Country	:	US
Telephone Number	:	915-544-1200
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S ZARAGOZA RD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-6635
Country	:	US
Telephone Number	:	915-790-5700
Fax Number	:

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

Provider Enumeration Date	:	05/01/2009
Last Update Date	:	06/25/2015

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