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General NPI Number Information
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NPI Number | 1972571743
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Entity Type | Individual
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Provider Name | ROXANNE MARIE TYROCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 154 N FESTIVAL DR # VILLA F
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City | EL PASO
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State | TX
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Zip | 79912-6266
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Country | US
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Telephone | 915-532-5858
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Fax | 915-532-5859
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Provider Business Mailing Address
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Address Line | 5823 N MESA ST # 537
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City | EL PASO
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State | TX
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Zip | 79912-4607
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Country | US
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Telephone | 915-261-4377
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Fax | 915-532-5859
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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 | K1945
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License Number State | TX
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