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1518568419
IAN MARDIS
EL PASO, TX
NPI
1518568419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: TX 1018941)
Enumeration Date
2020-11-05
Last Update Date
2020-11-13
Business Address
IAN MARDIS NP-C
12528 TIERRA ENCINO DR
EL PASO, TX 79938-4525
Phone number: 915-867-7097
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Mailing Address
IAN MARDIS NP-C
12528 TIERRA ENCINO DR
EL PASO, TX 79938-4525
Phone number:
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