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General NPI Number Information
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NPI Number | 1326027848
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Entity Type | Individual
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Provider Name | PEDRO NATIVIDAD JR. FNP
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 11450 GATEWAY BLVD N STE 1100
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City | EL PASO
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State | TX
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Zip | 79934-3460
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Country | US
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Telephone | 915-271-4635
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Fax |
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Provider Business Mailing Address
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Address Line | 4659 COHEN AVE UNIT A
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City | EL PASO
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State | TX
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Zip | 79924-4430
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Country | US
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Telephone | 915-881-3368
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Fax | 915-751-0464
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP103563
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License Number State | TX
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