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Organization
PWP INC
Active
Organization
PWP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL PETRUS PA (OWNER)
(915) 577-0111
Entity
Organization
Contact information
Practice address
1605 GEORGE DIETER 526, EL PASO, TX 79936
(915) 577-0111
Mailing address
1605 GEORGE DIETER DR, EL PASO, TX 79936-5600
(915) 577-0111
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
PA03331
TX
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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