Organization
LIA DAVALOS PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIA DAVALOS AGACNP-BC (NURSE PRACTITIONER)
(915) 615-7150
Entity
Organization
Contact information
Practice address
10470 VISTA DEL SOL DR, EL PASO, TX 79925-7948
(915) 615-7150
Mailing address
10470 VISTA DEL SOL DR STE 102, EL PASO, TX 79925-7928
(915) 615-7150
(915) 207-2143
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/14/2020
Last updated
05/05/2021
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