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General NPI Number Information
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NPI Number | 1457596991
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Entity Type | Organization
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Legal Business Name | SASHI II PA
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 09/13/2011
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Provider Practice Location Address
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Address Line | 1733 CURIE DR STE. 205
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City | EL PASO
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State | TX
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Zip | 79902-2910
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Country | US
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Telephone | 915-545-2054
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Fax | 915-545-5437
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Provider Business Mailing Address
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Address Line | 1733 CURIE DR STE. 205
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City | EL PASO
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State | TX
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Zip | 79902-2909
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Country | US
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Telephone | 915-545-2054
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Fax | 915-545-5437
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LELIA T GAINES
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Credential | M.D.
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Telephone | 915-545-2054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | J4812
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License Number State | TX
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