MEDICARE: DR. LUIS S NOBLE 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
1	207VE0102X	Reproductive Endocrinology Physician	J4394	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0018CV	OTHER	TX	BC/BS TX
2	00NM00YH89	OTHER	NM	BC/BS NM

General Provider Information

NPI Number	:	1649367285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS S NOBLE M.D.

Provider Business Mailing Address
First Line	:	700 S MESA HILLS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5504
Country	:	US
Telephone Number	:	915-842-9998
Fax Number	:	915-842-9972

Provider Business Practice Location Address
First Line	:	700 S MESA HILLS DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-5504
Country	:	US
Telephone Number	:	915-842-9998
Fax Number	:	915-842-9972

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	04/16/2008

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