Individual
MR. BRYAN M BACA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN
Contact information
Practice address
6211 EDGEMERE BLVD, SUITE 1, EL PASO, TX 79925-3413
(915) 881-8264
(915) 881-8082
Mailing address
10640 GATEWAY BLVD N, SUITE B, EL PASO, TX 79924-1700
(915) 307-4936
(915) 307-3683
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP131880
TX
Other
Enumeration date
10/03/2016
Last updated
02/09/2022
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