Provider Demographics
NPI:1275928954
Name:CEC EL PASO EAST ER PHYSICIANS PLLC
Entity Type:Organization
Organization Name:CEC EL PASO EAST ER PHYSICIANS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRAXTON
Authorized Official - Last Name:NEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:817-421-0034
Mailing Address - Street 1:PO BOX 92576
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-0576
Mailing Address - Country:US
Mailing Address - Phone:817-421-0034
Mailing Address - Fax:817-421-0036
Practice Address - Street 1:1890 GEORGE DIETER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-4327
Practice Address - Country:US
Practice Address - Phone:817-421-0034
Practice Address - Fax:817-421-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty