Individual
OMAR FAVELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
811 SIERRA ST, EL PASO, TX 79903-4818
(915) 345-9196
Mailing address
811 SIERRA ST, EL PASO, TX 79903-4818
(915) 345-9196
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
00021
TX
Other
Enumeration date
03/14/2012
Last updated
06/18/2019
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