Individual provider Active NPI

Coral Ledezma, MSN-FNPBC

  • Primary Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1689537359
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1216897 Issued in TX
Practice address
6974 Gateway Blvd E Ste E-F
El Paso, TX 79915-1118
Phone
(915) 591-2704
Fax
(915) 225-0413
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1216897 TX Primary

Addresses

Primary practice location

6974 Gateway Blvd E Ste E-F
El Paso, TX 79915-1118

Mailing address

6974 Gateway Blvd E Ste E-F
El Paso, TX 79915-1118
Phone (915) 591-2704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251218002727 TX Practitioner - Nurse Practitioner 3072008937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1335 Geronimo Dr
El Paso, TX 79925-1836

400 Shadow Mountain Dr
El Paso, TX 79912-4030

6974 Gateway Blvd E
Suite F
El Paso, TX 79915-1115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1216897TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salud Y Vida, P.a. CurrentSince Jan 5, 2026 Accepting new patients
Diagnostic Pro Imaging Past Accepting new patients

Locations

400 Shadow Mountain Dr
El Paso, TX 79912
Phone (915) 591-2700

3329 Montana Ave
El Paso, TX 79903
Phone (915) 562-7101

1335 Geronimo Dr
El Paso, TX 79925

6974 Gateway Blvd E
Ste F
El Paso, TX 79915
Phone (915) 540-4251

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1689537359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6974 GATEWAY BLVD E STE E-F",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151118",
            "telephone_number": "915-591-2704",
            "fax_number": "915-225-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6974 GATEWAY BLVD E STE E-F",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799151118",
            "telephone_number": "915-591-2704",
            "fax_number": "915-225-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDEZMA",
        "first_name": "CORAL",
        "credential": "MSN-FNPBC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1216897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.