Healthcare Provider Details

I. General information

NPI: 1306415492
Provider Name (Legal Business Name): MARIA JOSE MEJIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 ALBERTA AVE
EL PASO TX
79905-2707
US

IV. Provider business mailing address

4801 ALBERTA AVE
EL PASO TX
79905-2707
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-5000
  • Fax:
Mailing address:
  • Phone: 915-215-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number10094741
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: