Individual
LUIS S BAEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
10880 EDGEMERE BLVD, EL PASO, TX 79935-1306
(915) 590-7800
Mailing address
365 LA PUESTA DR APT 271, EL PASO, TX 79932-8513
(915) 207-4869
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210926
TX
Other
Enumeration date
01/31/2019
Last updated
01/31/2019
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