Provider Demographics
NPI:1780073593
Name:AVILA, CHRISTINA R (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:AVILA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5100 E PAISANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-3913
Mailing Address - Country:US
Mailing Address - Phone:915-774-2550
Mailing Address - Fax:915-774-2551
Practice Address - Street 1:5100 E PAISANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-3913
Practice Address - Country:US
Practice Address - Phone:915-774-2550
Practice Address - Fax:915-774-2551
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2014-0827207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM01203746Medicaid
NM465981YRNDOtherMEDICARE