Provider Demographics
NPI:1518264191
Name:RODOLFO FIERRO-STEVENS, M.D.
Entity Type:Organization
Organization Name:RODOLFO FIERRO-STEVENS, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AURORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-544-4911
Mailing Address - Street 1:1400 N EL PASO ST STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3438
Mailing Address - Country:US
Mailing Address - Phone:915-544-4911
Mailing Address - Fax:915-544-7610
Practice Address - Street 1:1400 N EL PASO ST STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3438
Practice Address - Country:US
Practice Address - Phone:915-544-4911
Practice Address - Fax:915-544-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ41112084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000T15S8Medicaid
TXP000T15S8Medicaid