Provider Demographics
NPI:1972668184
Name:EL PASO ANESTHESIA SPECIALISTS PA
Entity Type:Organization
Organization Name:EL PASO ANESTHESIA SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:STLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-774-5510
Mailing Address - Street 1:5959 GATEWAY BLVD W
Mailing Address - Street 2:STE 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3315
Mailing Address - Country:US
Mailing Address - Phone:915-774-5510
Mailing Address - Fax:915-779-1754
Practice Address - Street 1:5959 GATEWAY BLVD W
Practice Address - Street 2:STE 120
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-3331
Practice Address - Country:US
Practice Address - Phone:915-774-5510
Practice Address - Fax:915-779-1754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N81XOtherBCBS
TX094945502Medicaid
TX094945502Medicaid