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NPI Code Detail

MEDICARE: SURESH J ANTONY M D P A

MEDICARE: SURESH J ANTONY M D P A
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
1207R00000XInternal Medicine PhysicianK0610TX
2207RI0200XInfectious Disease PhysicianK0610TX

General Provider Information

NPI Number : 1902947724
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURESH J ANTONY M D P A
Provider Business Mailing Address
First Line : 1205 N OREGON ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-4023
Country : US
Telephone Number : 915-533-4900
Fax Number : 915-533-4902
Provider Business Practice Location Address
First Line : 1205 N OREGON ST
Second Line :
City : EL PASO
State : TX
Zip : 79902-4023
Country : US
Telephone Number : 915-533-4900
Fax Number : 915-533-4902
Authorized Official
Title or Position : PRESIDENT
Name : SURESH J ANTONY
Credential : MD
Telephone Number : 915-525-1138
Provider Enumeration Date : 02/12/2007
Last Update Date : 09/03/2013

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