Individual
CARLOS A. JESURUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 545-6817
(915) 545-9799
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6810
(915) 783-8187
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
E1877
TX
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
E1877
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135094406
—
TX
Enumeration date
08/16/2006
Last updated
11/17/2008
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