Provider Demographics
NPI:1811173289
Name:FEELY, ERIC JAMES (CRNA)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:JAMES
Last Name:FEELY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3416
Mailing Address - Country:US
Mailing Address - Phone:915-219-4300
Mailing Address - Fax:
Practice Address - Street 1:1300 MURCHISON DR STE 200
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4838
Practice Address - Country:US
Practice Address - Phone:915-219-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX697218367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079526OtherAANA #
TX697218OtherREGISTERED NURSE LIC#