MEDICARE: JOE MESSINGER A.T.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	AT1811	TX

General Provider Information

NPI Number	:	1285042770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOE MESSINGER A.T.C.

Provider Business Mailing Address
First Line	:	731 N YARBROUGH DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-2218
Country	:	US
Telephone Number	:	915-434-2000
Fax Number	:	915-593-6110

Provider Business Practice Location Address
First Line	:	731 N YARBROUGH DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79915-2218
Country	:	US
Telephone Number	:	915-434-2000
Fax Number	:	915-593-6110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2014
Last Update Date	:	07/28/2014

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