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NPI Code Detail

MEDICARE: GERARDO VAZQUEZ M.D.

MEDICARE: GERARDO VAZQUEZ M.D.
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
1207Q00000XFamily Medicine PhysicianP8560TX
2207QS0010XSports Medicine (Family Medicine) PhysicianP8560TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548588833
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERARDO VAZQUEZ M.D.
Provider Business Mailing Address
First Line : 106 MESA PARK DR STE 200
Second Line :
City : EL PASO
State : TX
Zip : 79912-6122
Country : US
Telephone Number : 915-300-3484
Fax Number :
Provider Business Practice Location Address
First Line : 106 MESA PARK DR STE 200
Second Line :
City : EL PASO
State : TX
Zip : 79912-6122
Country : US
Telephone Number : 915-300-3484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2010
Last Update Date : 01/22/2026

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Directions to “ GERARDO VAZQUEZ M.D.” Practice Location

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