Individual
DAISY MARAVILLA PROKSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 215-5700
Mailing address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 215-5700
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125.077554
IL
208600000X
Surgery Physician
Primary
BP10081555
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2021
Last updated
06/15/2022
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