Organization
BORDERLAND MEDICA, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALONSO GANDARA (MANAGER)
(915) 532-1197
Entity
Organization
Contact information
Practice address
1171 LARRY MAHAN DR, EL PASO, TX 79925-6509
(915) 532-1197
(915) 532-1198
Mailing address
1171 LARRY MAHAN DR, EL PASO, TX 79925-6509
(915) 532-1197
(915) 532-1198
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L8460
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L8460
TEXAS MEDICAL LICENSE
TX
Enumeration date
01/12/2012
Last updated
05/21/2024
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