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General NPI Number Information
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NPI Number | 1639179690
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Entity Type | Individual
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Provider Name | EDUARDO M DEJESUS-PERDOMO MD
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Gender | Male
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 7812 GATEWAY BLVD E STE 230
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City | EL PASO
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State | TX
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Zip | 79915-1802
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Country | US
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Telephone | 915-592-8223
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Fax | 915-592-8328
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Provider Business Mailing Address
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Address Line | 4445 N MESA ST STE 122
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City | EL PASO
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State | TX
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Zip | 79902-1117
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Country | US
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Telephone | 915-219-4300
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Fax | 915-519-4300
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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 | J8988
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J8988
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License Number State | TX
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