Individual
LUZ MARIA COUTTOLENC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6724 PINO REAL DR, EL PASO, TX 79912-2932
(915) 584-1247
(915) 832-0083
Mailing address
6724 PINO REAL DR, EL PASO, TX 79912-2932
(915) 584-1247
(915) 832-0083
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001004635
PROVIDER NUMBER
TX
Enumeration date
08/22/2007
Last updated
02/19/2019
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