Basic Information
Provider Information
NPI: 1518296185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONREAL
FirstName: FERNANDO
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4801 ALBERTA AVE
Address2: B3200
City: EL PASO
State: TX
PostalCode: 799052707
CountryCode: US
TelephoneNumber: 9155457333
FaxNumber:  
Practice Location
Address1: 4801 ALBERTA AVE
Address2: B3200
City: EL PASO
State: TX
PostalCode: 799052707
CountryCode: US
TelephoneNumber: 9155457333
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/10/2009
LastUpdateDate: 09/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XP7956TXN Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XMD2013-0686NMY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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