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General NPI Number Information
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NPI Number | 1053298216
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Entity Type | Individual
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Provider Name | JUAN ANZURES REGISTERED NURSE
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Gender | Male
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 4815 ALAMEDA AVE
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City | EL PASO
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State | TX
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Zip | 79905-2705
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Country | US
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Telephone | 915-534-3804
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Fax |
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Provider Business Mailing Address
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Address Line | 4640 ROBERT HOLT DR
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City | EL PASO
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State | TX
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Zip | 79924-6964
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Country | US
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Telephone | 915-253-5265
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PT0002X
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Taxonomy Name | Medical Toxicology (Emergency Medicine) Physician
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License Number | 512663
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 512663
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License Number State | TX
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