Individual
MRS. IRISH FAYE RIVERA PUGAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1485 GEORGE DIETER DR, SUITE 107, EL PASO, TX 79936-7650
(915) 790-5700
(915) 521-7082
Mailing address
1485 GEORGE DIETER DR, SUITE 107, EL PASO, TX 79936-7650
(915) 790-5700
(915) 521-7082
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.200174.RX
LA
363A00000X
Physician Assistant
Primary
PA07983
TX
Other
Enumeration date
10/04/2006
Last updated
02/06/2016
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