1922597301 NPI number — ALMA LILIANA MONROY TIJERINA MD

Table of content: ALMA LILIANA MONROY TIJERINA MD (NPI 1922597301)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922597301 NPI number — ALMA LILIANA MONROY TIJERINA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONROY TIJERINA
Provider First Name:
ALMA
Provider Middle Name:
LILIANA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922597301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5130 GATEWAY BLVD E # 51015
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79905-1608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-215-4480
Provider Business Mailing Address Fax Number:
915-215-5386

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 TRANSMOUNTAIN RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL PASO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79911-3602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-215-8400
Provider Business Practice Location Address Fax Number:
915-612-9254
Provider Enumeration Date:
05/01/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X , with the licence number: T4225 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: BP10065212 . This is a "OTHER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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