Organization
ENCHANTED DESERT EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS RONAN (VICE PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
900 W ASH ST, DEMING, NM 88030-4000
(505) 546-5879
Mailing address
13737 NOEL RD, STE 1600, DALLAS, TX 75240-1331
(469) 401-2386
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38650711
—
NM
Enumeration date
05/09/2006
Last updated
04/24/2014
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