Provider Demographics
NPI:1376131292
Name:OQUENDO, VICTOR MANUEL JR (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:MANUEL
Last Name:OQUENDO
Suffix:JR
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:5005 N PIEDRAS ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-5097
Mailing Address - Country:US
Mailing Address - Phone:915-742-2973
Mailing Address - Fax:915-742-4890
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79930-5097
Practice Address - Country:US
Practice Address - Phone:915-742-2973
Practice Address - Fax:915-742-4890
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
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Provider Licenses
StateLicense IDTaxonomies
1178803363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant