MEDICARE: MR. RAMON HOLGUIN

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1891039343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAMON HOLGUIN

Provider Business Mailing Address
First Line	:	1348 JESUS CHAVEZ PL
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79928-5254
Country	:	US
Telephone Number	:	915-849-8424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1348 JESUS CHAVEZ PL
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79928
Country	:	US
Telephone Number	:	915-849-8424
Fax Number	:

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

Provider Enumeration Date	:	11/22/2012
Last Update Date	:	08/15/2018

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