Provider Demographics
NPI:1225661564
Name:HEREKAR EG LLC
Entity Type:Organization
Organization Name:HEREKAR EG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AAMR
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-903-1715
Mailing Address - Street 1:7100 WESTWIND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1743
Mailing Address - Country:US
Mailing Address - Phone:505-903-1715
Mailing Address - Fax:
Practice Address - Street 1:7100 WESTWIND DR STE 300B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-1743
Practice Address - Country:US
Practice Address - Phone:505-903-1715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-14
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273100000XHospital UnitsEpilepsy Unit
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic