Healthcare Provider Details

I. General information

NPI: 1508558370
Provider Name (Legal Business Name): BERNARDO MANUEL TERRES JR. MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 10/13/2026
Certification Date: 10/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

11905 PASEO DEL REY DR
EL PASO TX
79936-3787
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-5700
  • Fax: 915-215-8872
Mailing address:
  • Phone: 915-545-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number766396
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: