Healthcare Provider Details

I. General information

NPI: 1568288843
Provider Name (Legal Business Name): ANA ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 HIGHLANDER MEDICS ST
FORT BLISS TX
79906-5327
US

IV. Provider business mailing address

14648 PETRALIA AVE
EL PASO TX
79938-2335
US

V. Phone/Fax

Practice location:
  • Phone: 915-892-5813
  • Fax:
Mailing address:
  • Phone: 915-588-4850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number760131
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: