Individual
THOMAS GLENN EASTER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2931 MONTANA AVE, SUITE A, EL PASO, TX 79903-2409
(915) 562-4246
(915) 564-0667
Mailing address
6938 ALTO REY AVE, STE 1003, EL PASO, TX 79912-3059
(915) 227-5545
(915) 584-1299
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G7801
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135303909
—
TX
01
—
P00681405
MEDICARE RR
TX
Enumeration date
08/11/2005
Last updated
12/28/2011
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