MEDICARE: ANU SKARIA GEORGE PAC

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	363A00000X	Physician Assistant		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306251780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANU SKARIA GEORGE PAC

Provider Business Mailing Address
First Line	:	1335 GERONIMO DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79925-1836
Country	:	US
Telephone Number	:	915-591-2704
Fax Number	:	915-225-0413

Provider Business Practice Location Address
First Line	:	6501 N MESA ST
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79912-4435
Country	:	US
Telephone Number	:	915-591-2704
Fax Number	:	915-225-0413

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

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	04/04/2016

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Directions to “ ANU SKARIA GEORGE PAC” Practice Location

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