Provider Demographics
NPI:1427897834
Name:ALFREDO MADRID PLLC
Entity type:Organization
Organization Name:ALFREDO MADRID PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MADRID
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:915-343-9702
Mailing Address - Street 1:1420 GERONIMO DRIVE
Mailing Address - Street 2:BUILDING C, SUITE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1855
Mailing Address - Country:US
Mailing Address - Phone:915-343-9702
Mailing Address - Fax:915-277-8661
Practice Address - Street 1:1420 GERONIMO DRIVE
Practice Address - Street 2:BUILDING C, SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1855
Practice Address - Country:US
Practice Address - Phone:915-343-9702
Practice Address - Fax:915-277-8661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty