Provider Demographics
NPI:1386071108
Name:PAYAN-BOWCUTT, LUISA (CNM)
Entity type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:PAYAN-BOWCUTT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4019 SANTA ANA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1321
Mailing Address - Country:US
Mailing Address - Phone:915-850-4458
Mailing Address - Fax:
Practice Address - Street 1:4824 ALBERTA AVE STE 403
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2709
Practice Address - Country:US
Practice Address - Phone:915-521-7839
Practice Address - Fax:915-521-7980
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX731197176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife