Individual
EDNA MARITZA JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 S. TELSHOR BLVD., BLDG. D., SUITE 1, LAS CRUCES, NM 88011
(575) 522-8641
Mailing address
3601 4TH ST, MS 9410, LUBBOCK, TX 79430-0002
(806) 743-3673
(806) 743-3560
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2018-0039
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2015
Last updated
05/21/2018
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