Provider Demographics
NPI:1659016053
Name:JAIME, JOSE ARTURO
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:ARTURO
Last Name:JAIME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 MOYE DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-5915
Mailing Address - Country:US
Mailing Address - Phone:915-873-4402
Mailing Address - Fax:
Practice Address - Street 1:1700 CURIE DR STE 2100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2981
Practice Address - Country:US
Practice Address - Phone:915-200-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65630101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health