Provider Demographics
NPI:1003814211
Name:TREMPER, LARRY JAY (DO)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:JAY
Last Name:TREMPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:LAWRENCE
Other - Middle Name:JAY
Other - Last Name:TREMPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:1201 E SCHUSTER AVE
Mailing Address - Street 2:5B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4672
Mailing Address - Country:US
Mailing Address - Phone:915-544-3229
Mailing Address - Fax:915-544-3091
Practice Address - Street 1:1201 E SCHUSTER AVE
Practice Address - Street 2:5B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4672
Practice Address - Country:US
Practice Address - Phone:915-544-3229
Practice Address - Fax:915-544-3091
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG57032080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110680902Medicaid
TX110680902Medicaid
TX0028BLMedicare ID - Type Unspecified