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General NPI Number Information
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NPI Number | 1205839594
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Entity Type | Organization
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Legal Business Name | SOUTHWEST ENDOCRINE CONSULTANTS
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 1201 E SCHUSTER AVE BLDG 7
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City | EL PASO
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State | TX
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Zip | 79902-4660
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Country | US
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Telephone | 915-533-5486
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Fax | 915-533-9602
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Provider Business Mailing Address
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Address Line | 1201 E SCHUSTER AVE BLDG 7
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City | EL PASO
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State | TX
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Zip | 79902-4660
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Country | US
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Telephone | 915-533-5486
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Fax | 915-533-9602
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Authorized Official
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Title or Position | ENDOCRINOLOGIST
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Name | WILBUR J STRADER
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Credential | M.D.
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Telephone | 915-533-5486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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