Healthcare Provider Details

I. General information

NPI: 1306027669
Provider Name (Legal Business Name): JUAN F. FERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7878 GATEWAY BLVD EAST SUITE 204
EL PASO TX
79915
US

IV. Provider business mailing address

7878 GATEWAY BLVD EAST SUITE 204
EL PASO TX
79915
US

V. Phone/Fax

Practice location:
  • Phone: 915-999-4009
  • Fax: 915-999-9089
Mailing address:
  • Phone: 915-999-4009
  • Fax: 915-999-9089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberP6815
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberP6815
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: