EDWARD C. JUAREZ, MD, PA (NPI# 1255318630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255318630 |
| Entity Type | Organization |
| Organization Name | EDWARD C. JUAREZ, MD, PA |
| Other Organization Name | EASTSIDE MEDICAL CARE CENTER, PA |
| Practice Address |
1721 N Lee Trevino Dr El Paso TX 79936-4521 |
| Mailing Address |
Po Box 12520 El Paso TX 79913-0520 |
| Practice Telephone | 9155909424 |
| Practice Fax Number | 9155909049 |
| Mailing Telephone | 9158420504 |
| Mailing Fax Number | 9158420448 |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2012-12-19 |
| Authorized Official Name | LAURENCE JUAREZ (ADMINISTRATOR) |
| Authorized Official Telephone | 9158420504 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | L0399 | 05 | |
| TX | 0858375-01 | 05 | |
| TX | PALMETTO GBA | CD3874 | 01 |
| Other Name | Type Code |
|---|---|
| Eastside Medical Care Center, PA | Doing Business As Name - Organization |
| Street Address |
1721 N LEE TREVINO DR |
| City | EL PASO |
| State | TX |
| Zip Code | 79936-4521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013917723 | William R. Vogt | Physician Assistant | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2005-07-22 |
| 1760933444 | Brandon Donald Gillett | Physical Therapist | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2016-10-18 |
| 1588047575 | Judith Sarah Salazar | Nurse Practitioner | 1721 N Lee Trevino Dr, El Paso, TX 79936 | 2015-07-08 |
| 1013244243 | Gerardo Anaya | Nurse Practitioner | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2009-11-09 |
| 1528292398 | Robert M Gutierrez | Nurse Practitioner | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2009-05-08 |
| 1497936959 | Eastside Occmed Center, Pa | Family Medicine | 1721 N Lee Trevino Dr, El Paso, TX 79936-4521 | 2007-11-26 |
| 1265559421 | Bobbi G Thomas | Nurse Practitioner | 1721 N Lee Trevino Dr, El Paso, TX 79936-4521 | 2007-03-23 |
| 1972658102 | Vista Hills Medical Equipment Corp. | Durable Medical Equipment & Medical Supplies | 1721 N Lee Trevino Dr, Suite 101a, El Paso, TX 79936-4521 | 2007-01-25 |
| 1588735948 | Joseph Delgado Chanoi | Physical Therapist | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2006-11-09 |
| 1003865551 | Denise L Jones | Nurse Practitioner | 1721 N Lee Trevino Dr, El Paso, TX 79936-4563 | 2006-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233171 | Center At Zaragoza, LLC | Skilled Nursing Facility | 12660 Pebble Hills Blvd., El Paso, TX 79936 | 2020-10-21 |
| 1346889953 | Georges Chiropractic and Wellness Center, Pa | Chiropractor | 1400 N Zaragosa Suite D, El Paso, TX 79936 | 2019-12-30 |
| 1316597768 | Larry Felix | Specialist/Technologist | 11720 Teachers Dr., El Paso, TX 79936 | 2019-09-18 |
| 1508323486 | Aaron John Palos | Pharmacist | 11320 Montwood, Pharmacy, El Paso, TX 79936 | 2019-02-27 |
| 1366919508 | Katrina Belvin | Social Worker | 1390 Georger Dieter Dr., #140, El Paso, TX 79936 | 2018-10-25 |
| 1063993244 | Assisted Living | Meals | 11065 Tom Weiskopf Dr, El Paso, TX 79936 | 2018-08-24 |
| 1588142962 | Miriam Salazar | Occupational Therapy Assistant | 1351 James Watt Dr., El Paso, TX 79936 | 2018-07-30 |
| 1902315179 | David Galindo | Occupational Therapist | 1415 Zaragoza, El Paso, TX 79936 | 2017-09-20 |
| 1861915589 | Lizette Salcido | Behavior Technician | 3221 Running Deer Dr., El Paso, TX 79936 | 2017-07-25 |
| 1659801264 | Edith Nneoma Vincent | Registered Nurse | 11829 Gwen Evans Ln, El Paso, TX 79936 | 2017-06-15 |
| Find all providers in zip 79936 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528683810 | Umc El Paso Healthcare Inc | General Practice | 7500 Viscount Blvd Ste 140, El Paso, TX 79925-5692 | 2020-06-11 |
| 1023580925 | Esperanza Medical and Wellness | General Practice | 12102 Montwood Dr Ste F, El Paso, TX 79936-4570 | 2018-12-18 |
| 1386177400 | Luis Rochin | General Practice | 3215 Gateway Blvd W Ste B, El Paso, TX 79903-4225 | 2017-04-05 |
| 1881041689 | Colin Patrick Martyn | General Practice | 13001 Eastlake Blvd Ste 105, El Paso, TX 79928-6312 | 2016-05-21 |
| 1437512506 | Chirag Acharya | General Practice | 5501 N Stanton St Apt 6, El Paso, TX 79912 | 2016-04-05 |
| 1851773907 | Remigio Flor | General Practice | Wbamc, 5005 N Piedras St, Mchm-dos-gsr, El Paso, TX 79920-5001 | 2015-06-25 |
| 1821483322 | Cesar Siska | General Practice | 1409 Likins, El Paso, TX 79925-7992 | 2015-04-01 |
| 1245644673 | Robert Jessie Atchison | General Practice | 5005 N. Piedras St. Attn: Gme, William Beaumont Army Medical Center, El Paso, TX 79920-5001 | 2014-06-13 |
| 1043548514 | Saw San | General Practice | Soldiers Family Medical Clinic -11th Abd Bde Surgeon, Fort Bliss, El Paso, TX 79916 | 2009-11-21 |
| 1124277629 | Denise Lavette Deshields | General Practice | 3901 State Jail Rd, El Paso, TX 79938-8465 | 2008-09-09 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.