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Individual

MR. SERGIO ENRIQUE CARRILLO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
4845 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 298-5444
Mailing address
4845 ALAMEDA AVE, EL PASO, TX 79905-2705
(915) 298-5444

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1115821
TX
363LF0000X
Family Nurse Practitioner
1115821
TX

Other

Enumeration date
06/20/2023
Last updated
10/20/2023
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