Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | K1387 | TX |
NPI | 1235242686 |
---|---|
Provider Name | Dr. Orest Andrew Chalupa |
First Address | El Paso, TX 79930-4210 |
Second Address | El Paso, TX 79930-4210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 08/07/2007 |