| NPI | 1649834904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA PADILLA Manager 505-385-9060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2021-10-04 |