Organization
DONIPHAN PEDIATRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS BREA (MANAGER)
(915) 478-4847
Entity
Organization
Contact information
Practice address
6621 DONIPHAN DR, SPACE D, CANUTILLO, TX 79835-5002
(915) 478-4847
(915) 577-9143
Mailing address
6621 DONIPHAN DR, SPACE D, CANUTILLO, TX 79835-5002
(915) 478-4847
(915) 577-9143
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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