Individual
EDGAR IVAN BUENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
12800 EDGEMERE BLVD STE B, EL PASO, TX 79938-4693
(915) 289-8988
Mailing address
12800 EDGEMERE BLVD STE B, EL PASO, TX 79938-4693
(915) 289-8988
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1099031
TX
363LA2200X
Adult Health Nurse Practitioner
1099031
TX
363LF0000X
Family Nurse Practitioner
1099031
TX
363LP2300X
Primary Care Nurse Practitioner
1099031
TX
Other
Enumeration date
04/07/2023
Last updated
04/14/2023
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