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General NPI Number Information
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NPI Number | 1710124490
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Entity Type | Organization
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Legal Business Name | TEXAS ANESTHESIA SPECIALISTS PA
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Dates
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Enumeration Date | 01/16/2009
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Last Update Date | 03/31/2009
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Provider Practice Location Address
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Address Line | 5959 GATEWAY BLVD W STE 120
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City | EL PASO
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State | TX
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Zip | 79925-3315
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Country | US
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Telephone | 915-779-1716
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 GATEWAY BLVD W STE 120
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City | EL PASO
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State | TX
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Zip | 79925-3315
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Country | US
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Telephone | 915-779-1716
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE AVILA-HERNANDEZ
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Credential | M.D.
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Telephone | 915-779-1716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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