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Organization
KRISTOFFERSON MEDICAL, PLLC
Active
Organization
KRISTOFFERSON MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEN KRISTOFFERSON P.A. (OWNER/PRESIDENT)
9159154741798
Entity
Organization
Contact information
Practice address
3280 JOE BATTLE BLVD, EL PASO, TX 79938-2622
(915) 474-1798
Mailing address
5959 GATEWAY BLVD W, SUITE 120, EL PASO, TX 79925-3331
(915) 779-1716
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02936
TX
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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