Healthcare Provider Details
I. General information
NPI: 1043184724
Provider Name (Legal Business Name): OTHON ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 DENVER AVE
EL PASO TX
79902-3008
US
IV. Provider business mailing address
5316 VICEROY DR
EL PASO TX
79924-2336
US
V. Phone/Fax
- Phone: 915-544-4000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ZULEMA
HERMOSILLO
Title or Position: DIRECTOR
Credential: CRNA
Phone: 915-494-9322