Provider Demographics
NPI:1386491843
Name:BARRON, JOSE LUIS
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:BARRON
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOSE
Other - Middle Name:LUIS
Other - Last Name:BARRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1201 AIRWAY BLVD STE D7
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3647
Mailing Address - Country:US
Mailing Address - Phone:915-329-1822
Mailing Address - Fax:
Practice Address - Street 1:1201 AIRWAY BLVD STE D7
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3647
Practice Address - Country:US
Practice Address - Phone:915-255-5037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXME8532225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist