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General NPI Number Information
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NPI Number | 1407979255
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Entity Type | Individual
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Provider Name | JOSE LEONARDO LOAIZA MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 10301 GATEWAY BLVD W
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City | EL PASO
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State | TX
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Zip | 79925-7701
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Country | US
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Telephone | 915-595-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 7100 WESTWIND DR STE 120
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City | EL PASO
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State | TX
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Zip | 79912-1757
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Country | US
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Telephone | 915-249-4676
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Fax | 915-255-0941
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | N0220
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2007-0124
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N0220
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License Number State | TX
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