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General NPI Number Information
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NPI Number | 1831077114
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Entity Type | Individual
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Provider Name | LAUREN BACA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 9555 DIANA DR
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City | EL PASO
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State | TX
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Zip | 79924-6951
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Country | US
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Telephone | 915-800-1106
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Fax |
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Provider Business Mailing Address
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Address Line | 5905 EMMITT SMITH ST
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City | EL PASO
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State | TX
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Zip | 79924-4440
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Country | US
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Telephone | 915-412-9295
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1026928
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License Number State | TX
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