Individual
JORGE ENRIQUE MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1512 N ZARAGOZA RD STE B, EL PASO, TX 79936-8903
(915) 213-0900
Mailing address
1512 N ZARAGOZA RD STE B, EL PASO, TX 79936-8903
(915) 213-0900
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
1073650
TX
363LC0200X
Critical Care Medicine Nurse Practitioner
1073650
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
1073650
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073650
NP LICENSE
TX
Enumeration date
04/05/2022
Last updated
10/03/2022
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