Individual
LISA AYOUB-RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4801 ALBERTA AVE, EL PASO, TX 79905-2707
(915) 545-6810
(915) 545-8859
Mailing address
4800 ALBERTA AVE STE 101, EL PASO, TX 79905-2709
(915) 545-6720
(915) 545-5755
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01069736A
IN
208000000X
Pediatrics Physician
Primary
43986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000717320
ANTHEM PROVIDER NUMBER
IN
05
—
201023560
—
IN
Enumeration date
04/17/2008
Last updated
10/17/2012
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