Provider Demographics
NPI:1689792475
Name:ACADEMY OF DIABETES, THYROID AND ENDOCRINE, P.A.
Entity Type:Organization
Organization Name:ACADEMY OF DIABETES, THYROID AND ENDOCRINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/VP
Authorized Official - Prefix:
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROVNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-356-2850
Mailing Address - Street 1:1516 LOMALAND DR.
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935
Mailing Address - Country:US
Mailing Address - Phone:915-593-2600
Mailing Address - Fax:915-593-2609
Practice Address - Street 1:1516 LOMALAND DR.
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-593-2600
Practice Address - Fax:915-593-2609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty