Provider Demographics
NPI:1467847947
Name:TIBREWAL, SAPNA (MD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:
Last Name:TIBREWAL
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 1:7888 GATEWAY BLVD E
Mailing Address - Street 2:STE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1815
Mailing Address - Country:US
Mailing Address - Phone:915-315-2584
Mailing Address - Fax:915-315-2585
Practice Address - Street 1:7888 GATEWAY BLVD E FL 2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1815
Practice Address - Country:US
Practice Address - Phone:915-315-2584
Practice Address - Fax:866-864-8671
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4486207W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program