| NPI | 1063639391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M WILSON Medical Doctor 505-878-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NM 96-161) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: NM 96-161) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |