Provider Demographics
NPI:1518918994
Name:DESERT WEST SURGERY, P.A.
Entity Type:Organization
Organization Name:DESERT WEST SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATUR
Authorized Official - Middle Name:A
Authorized Official - Last Name:KASHA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:915-313-9569
Mailing Address - Street 1:1600 MEDICAL CENTER DR STE 120
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:915-313-9569
Mailing Address - Fax:915-313-9102
Practice Address - Street 1:1600 MEDICAL CENTER DR STE 120
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-313-9569
Practice Address - Fax:915-313-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177571001Medicaid
TX177571002Medicaid
TX0061MYOtherBCBS
NM34552871Medicaid
TX177571001Medicaid
TXDE0371Medicare PIN