Provider Demographics
NPI:1710875331
Name:QUINTANILLA, ELISEO ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:ELISEO
Middle Name:ALBERTO
Last Name:QUINTANILLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:415 S MESA HILLS DR APT 1206
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5479
Mailing Address - Country:US
Mailing Address - Phone:626-848-6341
Mailing Address - Fax:
Practice Address - Street 1:4875 MAXWELL AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-1559
Practice Address - Country:US
Practice Address - Phone:915-465-0810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP100937112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry