Healthcare Provider Details

I. General information

NPI: 1083430789
Provider Name (Legal Business Name): VERONICA ROJO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 HIGHLANDER MEDICS ST
FORT BLISS TX
79906-5327
US

IV. Provider business mailing address

5909 WYMOND CT
EL PASO TX
79905-4740
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-0647
  • Fax:
Mailing address:
  • Phone: 915-873-2407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number863569
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: