MEDICARE: JESUS BAEZA MD

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	P7743	TX

General Provider Information

NPI Number	:	1750616462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESUS BAEZA MD

Provider Business Mailing Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:	915-260-4460
Fax Number	:	877-682-4629

Provider Business Practice Location Address
First Line	:	1150 BURGUNDY DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3462
Country	:	US
Telephone Number	:	915-260-4460
Fax Number	:	877-682-4629

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

Provider Enumeration Date	:	10/14/2009
Last Update Date	:	05/22/2026

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