MEDICARE: ORESTES MOLDES-RODRIGUEZ, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1366511818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORESTES MOLDES-RODRIGUEZ, M.D., P.A.

Provider Business Mailing Address
First Line	:	1600 N OREGON ST STE 1A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3595
Country	:	US
Telephone Number	:	915-532-2445
Fax Number	:	915-532-2673

Provider Business Practice Location Address
First Line	:	1600 N OREGON ST STE 1A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3595
Country	:	US
Telephone Number	:	915-532-2445
Fax Number	:	915-532-2673

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. CARMEN GALLO
Credential	:
Telephone Number	:	915-532-2445

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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