Healthcare Provider Details

I. General information

NPI: 1033643051
Provider Name (Legal Business Name): PRECISION HAND SURGERY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12770 EDGEMERE BLVD BLDG F
EL PASO TX
79938-4568
US

IV. Provider business mailing address

12770 EDGEMERE BLVD STE F
EL PASO TX
79938-4569
US

V. Phone/Fax

Practice location:
  • Phone: 915-249-4000
  • Fax: 915-206-5949
Mailing address:
  • Phone: 915-249-4000
  • Fax: 152-065-9499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberP8276
License Number StateTX

VIII. Authorized Official

Name: DR. JUSTIN S MITCHELL
Title or Position: OWNER
Credential: DO
Phone: 915-249-4000