Provider Demographics
NPI:1295733434
Name:ARMENDARIZ, EUGENIO M (MD)
Entity type:Individual
Prefix:
First Name:EUGENIO
Middle Name:M
Last Name:ARMENDARIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 N MESA ST
Mailing Address - Street 2:STE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1123
Mailing Address - Country:US
Mailing Address - Phone:915-532-2477
Mailing Address - Fax:915-532-2470
Practice Address - Street 1:4305 N MESA ST
Practice Address - Street 2:STE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1123
Practice Address - Country:US
Practice Address - Phone:915-532-2477
Practice Address - Fax:915-532-2470
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3036207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125086201Medicaid
TX125086201Medicaid
TXD33759Medicare UPIN