# SOUTHWEST PHYSICIAN GROUP PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720327059
- **Authorized official:** BRENT MICHENER D.O. (PHYSICIAN)
- **Authorized official phone:** (915) 855-2400

## Contact information

- **Practice address:** 3270 JOE BATTLE BLVD, 205, EL PASO, TX 79938-2639
- **Practice address phone:** (915) 855-2400
- **Practice address fax:** (915) 855-2401
- **Mailing address:** 3270 JOE BATTLE BLVD, 205, EL PASO, TX 79938-2639
- **Mailing address phone:** (915) 855-2400
- **Mailing address fax:** (915) 855-2401

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | N2838 | TX | Yes |
| 208600000X | Surgery Physician | M7798 | TX | — |

## Other

- **Enumeration date:** 02/06/2013
- **Last updated:** 02/06/2013