Healthcare Provider Details

I. General information

NPI: 1437164803
Provider Name (Legal Business Name): SERGIO F ROVNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 LOMALAND DR.
EL PASO TX
79935
US

IV. Provider business mailing address

1516 LOMALAND DR.
EL PASO TX
79935
US

V. Phone/Fax

Practice location:
  • Phone: 915-593-2600
  • Fax: 915-593-2609
Mailing address:
  • Phone: 915-593-2600
  • Fax: 915-593-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberK1037
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: