Provider Demographics
NPI:1952121287
Name:JUAREZ, ELOY (HIS)
Entity type:Individual
Prefix:
First Name:ELOY
Middle Name:
Last Name:JUAREZ
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-1817
Mailing Address - Country:US
Mailing Address - Phone:806-702-8208
Mailing Address - Fax:
Practice Address - Street 1:8838 VISCOUNT BLVD STE Q
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-5822
Practice Address - Country:US
Practice Address - Phone:806-702-8208
Practice Address - Fax:806-782-4327
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80924237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist