Healthcare Provider Details
I. General information
NPI: 1639266232
Provider Name (Legal Business Name): LUIS ENRIQUE LINAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/06/2006
Last Update Date: 02/13/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9817 N LAKE CREEK PKWY
AUSTIN TX
78717-6210
US
IV. Provider business mailing address
12081 PASEO DE AMOR LN
EL PASO TX
79936-4499
US
V. Phone/Fax
- Phone: 737-289-7100
- Fax: 737-289-7199
- Phone: 915-355-3660
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | H8214 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: