Basic Information
| Provider Information | |||||||||
| NPI: | 1477692465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASPONS | ||||||||
| FirstName: | ALDO | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5959 GATEWAY BLVD W | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799253331 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157791716 | ||||||||
| FaxNumber: | 9157716496 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E SCHUSTER AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799023556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9159297363 | ||||||||
| FaxNumber: | 8316277667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 03/15/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | P4349 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology | 208000000X | 2006-0350 | NM | N | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 304715101 | 05 | TX | MEDICAID | TXB161924 | 01 | TX | MEDICARE | OTHER |