| Jorge Natividad Avila Jr Md Pa | |
|
125 W Hague Rd Ste 250 El Paso TX 79902-5814 | |
| (915) 219-4100 | |
| Not Available |
| Full Name | Jorge Natividad Avila Jr Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 125 W Hague Rd Ste 250, El Paso, Texas |
| Authorized Official Name and Position | Jorge Avila (OWNER) |
| Authorized Official Contact | 8187494743 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge Natividad Avila Jr Md Pa 4849 N Mesa St Ste 201 El Paso TX 79912-5919 Ph: (915) 351-6600 | Jorge Natividad Avila Jr Md Pa 125 W Hague Rd Ste 250 El Paso TX 79902-5814 Ph: (915) 219-4100 |
| NPI Number | 1487163176 |
|---|---|
| Provider Enumeration Date | 09/25/2017 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Medicare PECOS PAC ID | 3274899885 |
|---|---|
| Medicare Enrollment ID | O20171115002202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487163176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jorge N Avila |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255538187 PECOS PAC ID: 6800038407 Enrollment ID: I20160727000289 |
| Provider Name | Oscar Demetrio Villalobos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528181492 PECOS PAC ID: 9436436748 Enrollment ID: I20170515000204 |
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