MEDICARE: WEST PEDIATRICS NIGHT CLINIC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1316373848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST PEDIATRICS NIGHT CLINIC PA

Provider Business Mailing Address
First Line	:	7208 LONGSPUR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79911-3090
Country	:	US
Telephone Number	:	915-351-9700
Fax Number	:	915-351-0320

Provider Business Practice Location Address
First Line	:	6901 HELEN OF TROY
Second Line	:	SUITE E-1
City	:	EL PASO
State	:	TX
Zip	:	79911-3043
Country	:	US
Telephone Number	:	915-351-0302
Fax Number	:	915-351-0320

Authorized Official
Title or Position	:	PRESIDENT
Name	:	OSAMA NAGA
Credential	:	M.D.
Telephone Number	:	915-841-9700

Provider Enumeration Date	:	09/16/2013
Last Update Date	:	09/16/2013

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