Healthcare Provider Details

I. General information

NPI: 1710390398
Provider Name (Legal Business Name): LAITH R DINKHA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 HIGHLANDER MEDICS ST
EL PASO TX
79906-5327
US

IV. Provider business mailing address

18511 HIGHLANDER MEDICS ST
EL PASO TX
79906-5327
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-7777
  • Fax:
Mailing address:
  • Phone: 915-742-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number1417
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1417
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberDO2023-1107
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberU8046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: