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NPI Code Detail

MEDICARE: PFD EL PASO PLLC

MEDICARE: PFD EL PASO PLLC
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1750077475
Entity Type Code : Organization
Provider Name (Legal Business Name) : PFD EL PASO PLLC
Provider Business Mailing Address
First Line : 10510 MONTWOOD DR STE B
Second Line :
City : EL PASO
State : TX
Zip : 79935-2717
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3501 PERSHING DR
Second Line :
City : EL PASO
State : TX
Zip : 79903-2731
Country : US
Telephone Number : 915-598-7264
Fax Number :
Authorized Official
Title or Position : OPERATIONS MANAGER
Name : HEATHER CORDOVA
Credential :
Telephone Number : 915-490-8698
Provider Enumeration Date : 04/14/2023
Last Update Date : 04/14/2023

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Directions to “PFD EL PASO PLLC ” Practice Location

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