Provider Demographics
NPI:1588244701
Name:OCHOA, ANAIS
Entity type:Individual
Prefix:
First Name:ANAIS
Middle Name:
Last Name:OCHOA
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 1:14668 LONG SHADOW AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-3128
Mailing Address - Country:US
Mailing Address - Phone:915-630-8004
Mailing Address - Fax:
Practice Address - Street 1:14476 HORIZON BLVD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-8579
Practice Address - Country:US
Practice Address - Phone:915-344-7011
Practice Address - Fax:915-344-7012
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031864363LP2300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty