Provider Demographics
NPI:1336366020
Name:GUILLERMO PARRA M.D.P.A.
Entity Type:Organization
Organization Name:GUILLERMO PARRA M.D.P.A.
Other - Org Name:FAMILY & OCCUPATIONAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-855-2005
Mailing Address - Street 1:3017 TRAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4330
Mailing Address - Country:US
Mailing Address - Phone:915-855-2005
Mailing Address - Fax:915-855-8400
Practice Address - Street 1:3017 TRAWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4330
Practice Address - Country:US
Practice Address - Phone:915-855-2005
Practice Address - Fax:915-855-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B3059Medicare ID - Type Unspecified
TXC20234Medicare UPIN