Healthcare Provider Details

I. General information

NPI: 1023321437
Provider Name (Legal Business Name): KRISTINA SINNOTT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 03/28/2024
Certification Date: 03/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TRANSMOUNTAIN RD STE B
EL PASO TX
79911-3602
US

IV. Provider business mailing address

5130 GATEWAY BLVD E
EL PASO TX
79905-1608
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-8400
  • Fax: 915-612-9253
Mailing address:
  • Phone: 915-215-4480
  • Fax: 915-215-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number54600
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301096990
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberV0172
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: