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General NPI Number Information
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NPI Number | 1366046542
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Entity Type | Individual
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Provider Name | LUIS ARIEL ACEVEDO
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Gender | Male
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Dates
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Enumeration Date | 11/28/2020
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Last Update Date | 11/28/2020
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Provider Practice Location Address
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Address Line | 300 S ZARAGOZA RD
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City | EL PASO
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State | TX
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Zip | 79907-6635
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Country | US
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Telephone | 915-790-5722
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Fax | 915-790-5721
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Provider Business Mailing Address
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Address Line | 1812 PASEO REAL CIR
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City | EL PASO
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State | TX
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Zip | 79936-3705
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Country | US
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Telephone | 915-204-4022
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 29194
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License Number State | TX
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