Provider Demographics
NPI:1114640729
Name:LOMELI, MIREYA LIANA (PA)
Entity type:Individual
Prefix:
First Name:MIREYA
Middle Name:LIANA
Last Name:LOMELI
Suffix:
Gender:F
Credentials:PA
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14363 EDGEMERE BLVD APT 707
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-5161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8045 N LOOP DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-3227
Practice Address - Country:US
Practice Address - Phone:915-444-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2024-11-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant