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General NPI Number Information
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NPI Number | 1235247750
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Entity Type | Organization
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Legal Business Name | ED JOSE BORREGO, MD, PA
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5750 N MESA ST
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City | EL PASO
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State | TX
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Zip | 79912-5427
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Country | US
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Telephone | 915-842-9585
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Fax | 915-842-9581
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Provider Business Mailing Address
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Address Line | 5750 N MESA ST
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City | EL PASO
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State | TX
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Zip | 79912-5427
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Country | US
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Telephone | 915-842-9585
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Fax | 915-842-9581
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Authorized Official
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Title or Position | PRESIDENT
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Name | ED JOSE BORREGO
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Credential | MD
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Telephone | 915-842-9585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | M0670
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License Number State | TX
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