Healthcare Provider Details
I. General information
NPI: 1013081207
Provider Name (Legal Business Name): EL PASO ORTHOPAEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 08/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10201 GATEWAY BLVD W #201
EL PASO TX
79925-7652
US
IV. Provider business mailing address
5823 N MESA PMB 843
EL PASO TX
79912
US
V. Phone/Fax
- Phone: 915-595-2700
- Fax: 915-591-1012
- Phone: 915-595-2700
- Fax: 915-591-1012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
NEUSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 915-595-2700