Most Relevant Information
Provider Data
| NPI Number: | 1003495912 |
| Provider Name: | BRYAN BOTELLO NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 1034153 |
Most Important Dates
| Enumeration Date: | 04/07/2021 |
| Last Updated: | 04/07/2021 |
Provider Practice Location
4305 N MESA ST
EL PASO
TX
799021123
Practice Location Phone/Fax
| Phone: | 9155322477 |
| Fax: | 9152426461 |
Provider Mailing Location
4305 N MESA ST STE A
EL PASO
TX
799021124
Provider Mailing Phone/Fax
| Phone: | 9155322477 |
| Fax: |