Provider Demographics
NPI:1225614910
Name:ESTRELLO, GUADALUPE (NP)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ESTRELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 VAN BUREN AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-4819
Mailing Address - Country:US
Mailing Address - Phone:915-503-8920
Mailing Address - Fax:
Practice Address - Street 1:1671 N ZARAGOZA RD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8058
Practice Address - Country:US
Practice Address - Phone:915-996-5210
Practice Address - Fax:915-213-5296
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144825363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily