Organization
EL PASO ANESTHESIOLOGY SERVICES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE VASQUEZ (CREDENTIALING MGR)
(915) 779-1716
Entity
Organization
Contact information
Practice address
5959 GATEWAY BLVD WEST, SUITE 120, EL PASO, TX 79925-3315
(915) 779-1716
(915) 771-6496
Mailing address
5959 GATEWAY BLVD WEST, SUITE 120, EL PASO, TX 79925-3315
(915) 779-1716
(915) 771-6496
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158783402
—
TX
01
—
DA2172
RAILROAD MEDICARE
TX
Enumeration date
07/27/2005
Last updated
04/24/2014
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