Healthcare Provider Details

I. General information

NPI: 1194907519
Provider Name (Legal Business Name): DEL NORTE EMERGENCY PHYSICIAN'S, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 CURIE DR STE A
EL PASO TX
79902-2920
US

IV. Provider business mailing address

2415 E YANDELL DR
EL PASO TX
79903-3616
US

V. Phone/Fax

Practice location:
  • Phone: 915-577-0111
  • Fax: 915-533-2568
Mailing address:
  • Phone: 915-577-0111
  • Fax: 915-533-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE B SUGAWA
Title or Position: MANAGER
Credential:
Phone: 915-577-0111