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Organization
SOUTHFORK ANESTHESIA PLLC
Active
Organization
SOUTHFORK ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI ROGLER CRNA (OWNER)
(208) 599-2277
Entity
Organization
Contact information
Practice address
1300 MURCHISON DR STE 200, EL PASO, TX 79902-4838
(915) 219-4300
Mailing address
1907 E YANDELL DR, EL PASO, TX 79903-3416
(915) 219-4300
(915) 519-4300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
811186
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4306491
—
MT
Enumeration date
07/10/2006
Last updated
05/03/2022
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