Provider Demographics
NPI:1851277750
Name:DEL REAL, LOURDES JACQUELINE (NP)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:JACQUELINE
Last Name:DEL REAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LOURDES
Other - Middle Name:JACQUELINE
Other - Last Name:TELLEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1024 ULTRASTAR PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-2346
Mailing Address - Country:US
Mailing Address - Phone:915-443-5952
Mailing Address - Fax:
Practice Address - Street 1:1625 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5005
Practice Address - Country:US
Practice Address - Phone:915-747-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1209452363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care