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Organization
SOUTHWEST PHYSICIAN GROUP PA
Active
Organization
SOUTHWEST PHYSICIAN GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT MICHENER D.O. (PHYSICIAN)
(915) 855-2400
Entity
Organization
Contact information
Practice address
3270 JOE BATTLE BLVD, 205, EL PASO, TX 79938-2639
(915) 855-2400
(915) 855-2401
Mailing address
3270 JOE BATTLE BLVD, 205, EL PASO, TX 79938-2639
(915) 855-2400
(915) 855-2401
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
N2838
TX
208600000X
Surgery Physician
M7798
TX
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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