Organization
4642 N MESA ER PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BRAXTON NEIMAN (GENERAL COUNSEL)
(817) 421-0034
Entity
Organization
Contact information
Practice address
4642 N MESA ST., EL PASO, TX 79912
(817) 421-0012
(817) 421-0036
Mailing address
910 S KIMBALL AVE, SOUTHLAKE, TX 76092-9005
(817) 421-0034
(817) 421-0036
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
02/05/2018
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