# 4642 N MESA ER PHYSICIANS PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1780197574
- **Authorized official:** JOHN BRAXTON NEIMAN (GENERAL COUNSEL)
- **Authorized official phone:** (817) 421-0034

## Contact information

- **Practice address:** 4642 N MESA ST., EL PASO, TX 79912
- **Practice address phone:** (817) 421-0012
- **Practice address fax:** (817) 421-0036
- **Mailing address:** 910 S KIMBALL AVE, SOUTHLAKE, TX 76092-9005
- **Mailing address phone:** (817) 421-0034
- **Mailing address fax:** (817) 421-0036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/15/2017
- **Last updated:** 02/05/2018