Provider Demographics
NPI:1497260160
Name:TRUJILLO, JOSHUA DAVID (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAVID
Last Name:TRUJILLO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6151 DEW DR STE 400
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3912
Mailing Address - Country:US
Mailing Address - Phone:915-217-2793
Mailing Address - Fax:
Practice Address - Street 1:1860 DEAN MARTIN DR STE 104
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3950
Practice Address - Country:US
Practice Address - Phone:915-855-7680
Practice Address - Fax:915-855-8640
Is Sole Proprietor?:No
Enumeration Date:2017-12-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA11675363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical