Healthcare Provider Details

I. General information

NPI: 1639361603
Provider Name (Legal Business Name): JENNIFER MARIE ORR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N MESA ST STE 200
EL PASO TX
79902-3554
US

IV. Provider business mailing address

1800 N MESA ST
EL PASO TX
79902-3553
US

V. Phone/Fax

Practice location:
  • Phone: 915-577-9900
  • Fax: 915-577-0200
Mailing address:
  • Phone: 915-577-9900
  • Fax: 915-577-0200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01063907A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberP2750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: