Healthcare Provider Details

I. General information

NPI: 1932240629
Provider Name (Legal Business Name): SOUTHWEST EAR NOSE & THROAT CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL CENTER DR STE 101
EL PASO TX
79902-5008
US

IV. Provider business mailing address

1600 MEDICAL CENTER STE 101
EL PASO TX
79902-5008
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-1350
  • Fax: 915-544-6740
Mailing address:
  • Phone: 915-544-1350
  • Fax: 915-544-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberK7250
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberJ9716
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberL7891
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberK7250
License Number StateTX

VIII. Authorized Official

Name: KEVIN E BRIGHT
Title or Position: PHYSICIAN
Credential: MD
Phone: 915-544-1350