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General NPI Number Information
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NPI Number | 1427056332
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Entity Type | Organization
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Legal Business Name | WEST STAR SURGICAL, P.A.
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2150 TRAWOOD DR STE A100
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City | EL PASO
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State | TX
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Zip | 79935-3322
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Country | US
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Telephone | 915-921-8500
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Fax | 915-921-8505
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Provider Business Mailing Address
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Address Line | 2150 TRAWOOD DR STE A100
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City | EL PASO
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State | TX
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Zip | 79935-3322
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Country | US
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Telephone | 915-921-8500
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Fax | 915-921-8505
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Authorized Official
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Title or Position | PRESIDENT
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Name | HENRY PAUL JR.
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Credential | M.D.
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Telephone | 915-921-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 13777
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License Number State | TX
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