Healthcare Provider Details

I. General information

NPI: 1891771416
Provider Name (Legal Business Name): JORGE G SAINZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 N MESA ST # B
EL PASO TX
79902-1105
US

IV. Provider business mailing address

4321 N MESA ST # B
EL PASO TX
79902-1105
US

V. Phone/Fax

Practice location:
  • Phone: 915-966-9700
  • Fax: 915-521-1743
Mailing address:
  • Phone: 915-966-9700
  • Fax: 915-521-1743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberL5542
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL5542
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: