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General NPI Number Information
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NPI Number | 1164670402
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Entity Type | Organization
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Legal Business Name | MATERN-ALL PA
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 10520 MONTWOOD DR
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City | EL PASO
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State | TX
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Zip | 79935-2703
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Country | US
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Telephone | 915-351-6600
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Fax | 915-351-6601
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Provider Business Mailing Address
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Address Line | PO BOX 920257
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City | EL PASO
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State | TX
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Zip | 79902-0006
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Country | US
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Telephone | 915-351-6600
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Fax | 915-351-6601
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS ARMANDO ZARATE
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Credential | MD
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Telephone | 915-351-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | M9759
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License Number State | TX
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