IAN MARDIS (NPI# 1518568419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518568419 |
| Entity Type | Individual |
| Full Name | IAN MARDIS |
| Credential | NP-C |
| Practice Address |
12528 Tierra Encino Dr El Paso TX 79938-4525 |
| Practice Telephone | 9158677097 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1018941 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12528 TIERRA ENCINO DR |
| City | EL PASO |
| State | TX |
| Zip Code | 79938-4525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962047795 | Brooke Raanne Beaver | Behavioral Analyst | Wells Fargo Plaza, Kansas St # 700, El Paso, TX 79938 | 2019-11-15 |
| 1386109635 | Judith Roman | Nurse Practitioner | 12810 Edgemere, El Paso, TX 79938 | 2019-01-31 |
| 1033681564 | Project Vida Health Center | Clinic/Center | 3216 Tim Foster Street, El Paso, TX 79938 | 2018-12-21 |
| 1851868384 | Possibilities Speculation, Pllc | Dentist | 2260 N Zaragoza Rd Unit A112, El Paso, TX 79938 | 2018-11-02 |
| 1578030276 | Connor Family Dentistry East Pllc | Dentist | 1920 N. Zaragoza Rd., Suite 107, El Paso, TX 79938 | 2018-10-31 |
| 1952895039 | Marlen Hernandez Cortez | Behavior Technician | 15165 Snohomish Loop, El Paso, TX 79938 | 2018-06-21 |
| 1497287155 | Assisting Alliance L.L.C. | Physician Assistant | 14048 Oso Rock Way, El Paso, TX 79938 | 2017-03-31 |
| 1619428703 | Sege Medical PC | Family Medicine | 2260 N Zaragoza, Suite A118, El Paso, TX 79938 | 2016-10-24 |
| 1891148110 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 12051 Tierra Este Rd, El Paso, TX 79938 | 2016-07-21 |
| 1639538077 | Early Bird Pediatric Therapy Clinic, Inc | Occupational Therapist | 2114 N Zaragoza Rd Ste C1, El Paso, TX 79938 | 2016-02-13 |
| Find all providers in zip 79938 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062172 | Cinthia B Gomez | Nurse Practitioner | 8401 Edgemere Blvd, El Paso, TX 79925-3922 | 2020-11-01 |
| 1407456072 | Aurora Nichole Apodaca | Nurse Practitioner | 748 Tepic Dr, El Paso, TX 79912-1704 | 2020-10-31 |
| 1043818412 | Ricardo Serrano | Nurse Practitioner | 4300 Bliss Ave, El Paso, TX 79903-1832 | 2020-10-16 |
| 1841897212 | Olivia Silva Juarez | Nurse Practitioner | 617 Paseo Hermoso Dr, El Paso, TX 79928-8419 | 2020-10-07 |
| 1609480540 | Norma M Vega | Nurse Practitioner | 6974 Gateway Blvd E Ste Y, El Paso, TX 79915-1118 | 2020-09-08 |
| 1952914087 | Danika Nikole Davila | Nurse Practitioner | 3270 Joe Battle Blvd Ste 245, El Paso, TX 79938-2651 | 2020-08-28 |
| 1841803095 | Joshua Neal Crawford | Nurse Practitioner | 10615 Sombra Verde Dr, El Paso, TX 79935-3612 | 2020-08-27 |
| 1902419294 | Belinda Esperanza Walker | Nurse Practitioner | 3405 Moonlight Ave, El Paso, TX 79904-1024 | 2020-08-26 |
| 1487264198 | Venessa Jean Tellez | Nurse Practitioner | 10800 Walden Pond St, El Paso, TX 79924-2407 | 2020-08-06 |
| 1801414412 | Gynna Carbajal Bustos | Nurse Practitioner | 710 Warwickshire Ave, El Paso, TX 79928-2200 | 2020-07-09 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.