Basic Information
| Provider Information | |||||||||
| NPI: | 1558823716 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUGUIRO | ||||||||
| FirstName: | ANGELO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5020 N DESERT BLVD BLDG C1A | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799121662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157608830 | ||||||||
| FaxNumber: | 9158750476 | ||||||||
| Practice Location | |||||||||
| Address1: | 5020 N DESERT BLVD BLDG C1A | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799121662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9157608830 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2019 | ||||||||
| LastUpdateDate: | 04/04/2019 | ||||||||
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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 | 237700000X | 80753 | TX | Y | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist |
No ID Information.