Organization
EL PASO INFECTIOUS DISEASES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELYN ANN GOUVEIA D.O. (PHYSICIAN - OWNER)
(915) 400-2600
Entity
Organization
Contact information
Practice address
1250 E CLIFF DR STE 5F, EL PASO, TX 79902-4850
(915) 400-2600
(915) 591-9215
Mailing address
1250 E CLIFF DR STE 5F, EL PASO, TX 79902-4850
(915) 400-2600
(915) 249-4355
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
M8004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M8004
TX MEDICAL LICENSE
TX
Enumeration date
01/14/2014
Last updated
09/17/2019
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