Individual
ISAAC ADRIAN BENCOMO BERMUDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN CPNP-PC
Contact information
Practice address
2418 N KANSAS ST APT A, EL PASO, TX 79902-3104
(915) 433-1291
Mailing address
2418 N KANSAS ST APT A, EL PASO, TX 79902-3104
(915) 433-1291
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
860434
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
AP141902
TX
Other
Enumeration date
05/31/2020
Last updated
05/31/2020
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