Healthcare Provider Details

I. General information

NPI: 1740730787
Provider Name (Legal Business Name): HENRY WALDON SAVERY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 N PIEDRAS ST
EL PASO TX
79920-5002
US

IV. Provider business mailing address

5005 N PIEDRAS ST
EL PASO TX
79920-5002
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-2421
  • Fax:
Mailing address:
  • Phone: 915-742-2421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberC41103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: