Provider Demographics
NPI:1235727397
Name:SUNDESERT NEUROLOGY PLLC
Entity Type:Organization
Organization Name:SUNDESERT NEUROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-809-4194
Mailing Address - Street 1:2311 N MESA ST STE F
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3575
Mailing Address - Country:US
Mailing Address - Phone:915-544-6400
Mailing Address - Fax:
Practice Address - Street 1:2311 N MESA ST STE F
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3575
Practice Address - Country:US
Practice Address - Phone:915-544-6400
Practice Address - Fax:915-544-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty