Provider Demographics
NPI:1548489248
Name:SERNA, AIME D (MD)
Entity type:Individual
Prefix:
First Name:AIME
Middle Name:D
Last Name:SERNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CURIE DR STE 5000
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2988
Mailing Address - Country:US
Mailing Address - Phone:915-532-7881
Mailing Address - Fax:915-532-0939
Practice Address - Street 1:100 EXECUTIVE CENTER BLVD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1102
Practice Address - Country:US
Practice Address - Phone:915-532-7881
Practice Address - Fax:915-532-0939
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
8B8102Medicare ID - Type Unspecified
H38480Medicare UPIN