MEDICARE: DONYA ANESTHESIA ENTERPRISE PLLC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1528523255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONYA ANESTHESIA ENTERPRISE PLLC

Provider Business Mailing Address
First Line	:	7340 CIMARRON MARKET AVE
Second Line	:	BUILDING A STE A
City	:	EL PASO
State	:	TX
Zip	:	79912-0061
Country	:	US
Telephone Number	:	915-234-2268
Fax Number	:

Provider Business Practice Location Address
First Line	:	7340 CIMARRON MARKET AVE BUILDING A
Second Line	:	SUITE A
City	:	EL PASO
State	:	TX
Zip	:	79912-0061
Country	:	US
Telephone Number	:	915-234-2268
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	ALI IBRAHIM
Credential	:	MD
Telephone Number	:	317-441-8090

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	08/05/2024

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