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Organization

SOUTHWEST ANESTHESIA GROUP, P.A.

Active
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Organization

SOUTHWEST ANESTHESIA GROUP, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK GAN D.O. (PHYSICIAN)
(915) 779-1716
Entity
Organization

Contact information

Practice address
5959 GATEWAY BLVD W, STE. 120, EL PASO, TX 79925-3331
(915) 774-5539
(915) 771-6558
Mailing address
5959 GATEWAY BLVD W, STE. 120, EL PASO, TX 79925-3331
(915) 774-5539
(915) 771-6558

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K80Q
BCBS
TX
05
—
094933101
—
TX
Enumeration date
09/16/2006
Last updated
11/14/2008
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