Healthcare Provider Details

I. General information

NPI: 1336366020
Provider Name (Legal Business Name): GUILLERMO PARRA M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3017 TRAWOOD DR
EL PASO TX
79936-4330
US

IV. Provider business mailing address

3017 TRAWOOD DR
EL PASO TX
79936-4330
US

V. Phone/Fax

Practice location:
  • Phone: 915-855-2005
  • Fax: 915-855-8400
Mailing address:
  • Phone: 915-855-2005
  • Fax: 915-855-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GUILLERMO PARRA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 915-855-2005