NPIMap

Organization Active NPI

Edward C. Juarez, MD, PA

Doing business as Eastside Medical Care Center, PA

  • General Practice Physician
  • El Paso, TX
National Provider Identifier
1255318630
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EDWARD C. JUAREZ, MD, PA
Doing business as
Eastside Medical Care Center, PA
Practice address
1721 N Lee Trevino Dr
El Paso, TX 79936-4521
Phone
(915) 590-9424
Fax
(915) 590-9049
NPI assigned
Dec 28, 2005
Last updated
Dec 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurence Juarez
Title
Administrator
Phone
(915) 842-0504

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

1721 N Lee Trevino Dr
El Paso, TX 79936-4521

Mailing address

PO Box 12520
El Paso, TX 79913-0520
Phone (915) 842-0504

Other identifiers 3

IdentifierTypeStateIssuer
L0399MedicaidNM
0858375-01MedicaidTX
CD3874OtherTXPALMETTO GBA

Other names 1

  • Eastside Medical Care Center, PA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1255318630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12520",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799130520",
            "telephone_number": "915-842-0504",
            "fax_number": "915-842-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 N LEE TREVINO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799364521",
            "telephone_number": "915-590-9424",
            "fax_number": "915-590-9049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD C. JUAREZ, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "JUAREZ",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "915-842-0504"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L0399",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0858375-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CD3874",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Medical Care Center, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.