Provider Demographics
NPI:1699009456
Name:EDDIE NASSAR MD PA
Entity Type:Organization
Organization Name:EDDIE NASSAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-881-4225
Mailing Address - Street 1:5000 DONIPHAN DR
Mailing Address - Street 2:STE 104
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1619
Mailing Address - Country:US
Mailing Address - Phone:915-881-4225
Mailing Address - Fax:915-881-4197
Practice Address - Street 1:5000 DONIPHAN DR
Practice Address - Street 2:STE 104
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79932-1619
Practice Address - Country:US
Practice Address - Phone:915-881-4225
Practice Address - Fax:915-881-4197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty