EP MODERN MEDICINE PLLC NPI 1417723693

NPI Information

  • NPI: 1417723693
  • Provider Name: EP MODERN MEDICINE PLLC
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: EP PREVENTIVE CARE
  • CLIA Number: 45D2308007
  • Address: 154 N FESTIVAL DR STE A
    EL PASO, TX
    ZIP 79912
  • Phone: (915) 328-6233

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NPI Details

EP MODERN MEDICINE PLLC is a family nurse practitioner in El Paso, TX. EP MODERN MEDICINE PLLC NPI is 1417723693. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ep Preventive Care.

The provider's business location address is:

154 N FESTIVAL DR STE A
EL PASO, TX
ZIP 79912-265
Phone: (915) 328-6233
Fax: (915) 779-9797

The provider's authorized official is Maribel Magallanes .
The authorized official title is President and has the following contact phone number (915) 228-3080.

The CLIA number assigned to this NPI record is 45D2308007 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/29/2023 and was last updated on 5/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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