MEDICARE: CARLOS H. LOUBRIEL 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	207V00000X	Obstetrics & Gynecology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00499T	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1669586392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS H. LOUBRIEL M.D., P.A.

Provider Business Mailing Address
First Line	:	5959 GATEWAY BLVD W
Second Line	:	STE. 120
City	:	EL PASO
State	:	TX
Zip	:	79925-3331
Country	:	US
Telephone Number	:	915-779-1716
Fax Number	:	915-771-6558

Provider Business Practice Location Address
First Line	:	4242 HONDO PASS DR
Second Line	:	STE. 101
City	:	EL PASO
State	:	TX
Zip	:	79904-1205
Country	:	US
Telephone Number	:	915-759-8555
Fax Number	:	915-759-8522

Authorized Official
Title or Position	:	OWNER
Name	:	CARLOS H. LOUBRIEL
Credential	:	M.D.
Telephone Number	:	915-759-8555

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	08/22/2020

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