Provider Demographics
NPI:1568650992
Name:MONROY, ANWAR EDUARDO (MD)
Entity Type:Individual
Prefix:
First Name:ANWAR
Middle Name:EDUARDO
Last Name:MONROY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANWAR
Other - Middle Name:EDUARDO
Other - Last Name:MONROY FERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11351 JAMES WATT DR BLDG E
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6627
Mailing Address - Country:US
Mailing Address - Phone:915-317-7699
Mailing Address - Fax:210-504-1439
Practice Address - Street 1:11351 JAMES WATT DR BLDG E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6627
Practice Address - Country:US
Practice Address - Phone:915-317-7699
Practice Address - Fax:210-504-1439
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNBP1-0028932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX414013Medicare PIN