Provider Demographics
NPI:1851069546
Name:CARES MEDICAL CLINIC, PLLC
Entity Type:Organization
Organization Name:CARES MEDICAL CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MONAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-300-0067
Mailing Address - Street 1:3130 N LEE TREVINO DR STE 114A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-2179
Mailing Address - Country:US
Mailing Address - Phone:915-300-0067
Mailing Address - Fax:915-300-0044
Practice Address - Street 1:3130 N LEE TREVINO DR STE 114A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2179
Practice Address - Country:US
Practice Address - Phone:915-300-0067
Practice Address - Fax:915-300-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013462274OtherPRIVATE PAY