Healthcare Provider Details

I. General information

NPI: 1780147017
Provider Name (Legal Business Name): NORBERT DONIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 VISTA DEL SOL DR STE 100
EL PASO TX
79925-7928
US

IV. Provider business mailing address

10470 VISTA DEL SOL DR STE 100
EL PASO TX
79925-7928
US

V. Phone/Fax

Practice location:
  • Phone: 915-615-7005
  • Fax:
Mailing address:
  • Phone: 915-615-7005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV4369
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberV4369
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: