Individual
DR. JONATHAN LYNN LAVEZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4815 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 215-4956
(915) 215-4770
Mailing address
5130 GATEWAY BLVD E # 51015, EL PASO, TX 79905-1608
(915) 215-4480
(915) 215-5386
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
S6875
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
S6875
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2015
Last updated
11/08/2023
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