Provider Demographics
NPI:1265485932
Name:IBARRA, ISELA (MD)
Entity Type:Individual
Prefix:
First Name:ISELA
Middle Name:
Last Name:IBARRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3917 N MESA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1501
Mailing Address - Country:US
Mailing Address - Phone:915-544-5439
Mailing Address - Fax:915-544-5445
Practice Address - Street 1:3917 N MESA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1501
Practice Address - Country:US
Practice Address - Phone:915-544-5439
Practice Address - Fax:915-544-5445
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8739208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics