Healthcare Provider Details

I. General information

NPI: 1174012348
Provider Name (Legal Business Name): HEREKAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 WESTWIND DR STE 300
EL PASO TX
79912-1743
US

IV. Provider business mailing address

7100 WESTWIND DR STE 300
EL PASO TX
79912-1743
US

V. Phone/Fax

Practice location:
  • Phone: 915-974-2200
  • Fax: 855-888-3172
Mailing address:
  • Phone: 915-974-2200
  • Fax: 855-888-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AAMR ARIF HEREKAR
Title or Position: CEO
Credential:
Phone: 505-903-1715