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NPI Code Detail

MEDICARE: MARIA JOSE IBARRA

MEDICARE: MARIA JOSE IBARRA
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
1363A00000XPhysician AssistantTX

General Provider Information

NPI Number : 1396528394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA JOSE IBARRA
Provider Business Mailing Address
First Line : 3600 N GARFIELD ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-6329
Country : US
Telephone Number : 432-620-1120
Fax Number :
Provider Business Practice Location Address
First Line : 3600 N GARFIELD ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-6329
Country : US
Telephone Number : 432-620-1120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2023
Last Update Date : 06/02/2026

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Directions to “ MARIA JOSE IBARRA ” Practice Location

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