Healthcare Provider Details

I. General information

NPI: 1003506098
Provider Name (Legal Business Name): OMER USMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 TRANSMOUTAIN RD
EL PASO TX
79911
US

IV. Provider business mailing address

2000 TRANSMOUTAIN RD
EL PASO TX
79911
US

V. Phone/Fax

Practice location:
  • Phone: 915-215-8400
  • Fax:
Mailing address:
  • Phone: 915-215-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10085788
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: