Healthcare Provider Details

I. General information

NPI: 1043729817
Provider Name (Legal Business Name): SOUTHWEST MEDICAL DEVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E MILLS AVE SUITE C
EL PASO TX
79901
US

IV. Provider business mailing address

212 E MILLS AVE SUITE C
EL PASO TX
79901
US

V. Phone/Fax

Practice location:
  • Phone: 915-444-5155
  • Fax: 915-444-5154
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: KARLA TAFOYA
Title or Position: BILLING MANAGER
Credential:
Phone: 915-875-1801