Individual
DR. JORGE IVAN CONTRERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5959 GATEWAY BLVD W, 160, EL PASO, TX 79925-3331
(915) 779-1716
Mailing address
5959 GATEWAY BLVD W, 160, EL PASO, TX 79925-3331
(915) 779-1716
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
P7624
TX
207Y00000X
Otolaryngology Physician
RS20070279
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RS20070279
TRAINING
NM
Enumeration date
06/22/2007
Last updated
08/26/2013
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