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1952560682
MAURO PROVENCIO
EL PASO, TX
NPI
1952560682
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: TX P1809)
Enumeration Date
2008-06-06
Last Update Date
2024-02-28
Business Address
Dr. MAURO PROVENCIO M.D.
12810 EDGEMERE BLVD
EL PASO, TX 79938-4532
Phone number: 915-504-6955
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Mailing Address
Dr. MAURO PROVENCIO M.D.
12810 EDGEMERE BLVD
EL PASO, TX 79938-4532
Phone number: 915-504-6955
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