Individual
ED JOSE BORREGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5750 N MESA ST, EL PASO, TX 79912-5427
(915) 842-9585
(915) 842-9581
Mailing address
5736 N MESA ST, EL PASO, TX 79912-5427
(915) 842-9585
(915) 842-9581
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
M0670
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00336Z
MEDICARE PTAN
TX
05
—
176353401
—
TX
Enumeration date
08/03/2005
Last updated
02/16/2010
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