Healthcare Provider Details

I. General information

NPI: 1487138707
Provider Name (Legal Business Name): MICHELLE CAMARILLO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 N PIEDRAS ST
EL PASO TX
79930-4210
US

IV. Provider business mailing address

5864 VALLEY PALM DR
EL PASO TX
79932-2259
US

V. Phone/Fax

Practice location:
  • Phone: 915-564-6100
  • Fax:
Mailing address:
  • Phone: 915-227-3094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number60682
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: