Provider Demographics
NPI:1114722055
Name:AMADOR, LUZ ANGELICA
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:ANGELICA
Last Name:AMADOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 ESPOLON DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1708
Mailing Address - Country:US
Mailing Address - Phone:915-244-2428
Mailing Address - Fax:
Practice Address - Street 1:829 ESPOLON DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1708
Practice Address - Country:US
Practice Address - Phone:915-244-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service