MEDICARE: OLIVIA S JUAREZ FNP-C PRIMARY CARE CLINIC LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1437044583
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVIA S JUAREZ FNP-C PRIMARY CARE CLINIC LLC

Provider Business Mailing Address
First Line	:	7812 GATEWAY BLVD E STE 200
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-1836
Country	:	US
Telephone Number	:	915-671-2266
Fax Number	:	915-221-0776

Provider Business Practice Location Address
First Line	:	7812 GATEWAY BLVD E STE 200
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-1836
Country	:	US
Telephone Number	:	915-219-4246
Fax Number	:

Authorized Official
Title or Position	:	FNP/OWNER
Name	:	MRS. OLIVIA JUAREZ
Credential	:	FNP
Telephone Number	:	915-256-1131

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	03/27/2026

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