Individual
MR. EDWARD MARK FAVELA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1514 N ZARAGOZA RD STE B4, EL PASO, TX 79936-8041
(915) 257-5782
Mailing address
1514 N ZARAGOZA RD STE B4, EL PASO, TX 79936-8041
(915) 257-5782
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
215683
TX
224Z00000X
Occupational Therapy Assistant
Primary
5202008595
MI
Other
Enumeration date
07/05/2019
Last updated
07/08/2020
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