Basic Information
Provider Information
NPI: 1508025511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OPINA
FirstName: MARIA THERESA
MiddleName: DEGRACIA
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 440 RAYNOLDS ST # 51015
Address2:  
City: EL PASO
State: TX
PostalCode: 799051613
CountryCode: US
TelephoneNumber: 9152154480
FaxNumber: 9152155386
Practice Location
Address1: 2000B TRANS MOUNTAIN RD
Address2:  
City: EL PASO
State: TX
PostalCode: 79911
CountryCode: US
TelephoneNumber: 9152158400
FaxNumber: 9156129254
Other Information
ProviderEnumerationDate: 06/04/2008
LastUpdateDate: 10/31/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XS2863TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X4301092718MIN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X2016-01478NCN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RP1001XS2863TXY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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