| Modern Md Pllc | |
|
5915 Silver Springs Dr Bldg 3a El Paso TX 79912-4126 | |
| (915) 228-3080 | |
| Not Available |
| Full Name | Modern Md Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5915 Silver Springs Dr Bldg 3a, El Paso, Texas |
| Authorized Official Name and Position | Patricia Lopez-po (PRESIDENT) |
| Authorized Official Contact | 9152283080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Md Pllc 4849 N Mesa St Ste 201 El Paso TX 79912-5919 Ph: (915) 351-6600 | Modern Md Pllc 5915 Silver Springs Dr Bldg 3a El Paso TX 79912-4126 Ph: (915) 228-3080 |
| NPI Number | 1104412931 |
|---|---|
| Provider Enumeration Date | 12/16/2020 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 9133532542 |
|---|---|
| Medicare Enrollment ID | O20210104000851 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104412931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Patricia Lopez Po |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467797811 PECOS PAC ID: 5799750733 Enrollment ID: I20040901000723 |
| Provider Name | Vivian Villarreal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952572166 PECOS PAC ID: 1850453838 Enrollment ID: I20081230000026 |
| Provider Name | Marcelita P Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417109513 PECOS PAC ID: 8729136114 Enrollment ID: I20090422000675 |
| Provider Name | Taron Taray Peebles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437423696 PECOS PAC ID: 6901061746 Enrollment ID: I20120629000347 |
| Provider Name | Karina Mendoza-marcial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902456452 PECOS PAC ID: 0345572293 Enrollment ID: I20191028000514 |
| Provider Name | Maribel Magallanes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912574781 PECOS PAC ID: 1951704808 Enrollment ID: I20210729001720 |
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