Provider Demographics
NPI:1598403826
Name:CONTRERAS, ELSA MARGARITA
Entity Type:Individual
Prefix:MS
First Name:ELSA
Middle Name:MARGARITA
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10165 BERMUDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5416
Mailing Address - Country:US
Mailing Address - Phone:915-412-1373
Mailing Address - Fax:
Practice Address - Street 1:10165 BERMUDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5416
Practice Address - Country:US
Practice Address - Phone:915-412-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0037143376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037143OtherASSISTED LIVING FACILITY