Individual
VINCENT ANDREW MINJAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1780 E UNIVERSITY AVE, LAS CRUCES, NM 88003-1229
(575) 646-0111
Mailing address
5863 OLEASTER DR, EL PASO, TX 79932-2338
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
ATHLETIC TRAINING TAXONOMY CODE
NM
01
—
390200000X
STUDENT TAXONOMY CODE
NM
Enumeration date
01/19/2015
Last updated
01/19/2015
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