Internal Medicine Premium Health Care Pc

NPI 1124406269 - Internal Medicine - 207R00000X

NPI Details
NPI 1124406269
Enumeration Date 05/08/2015
Last Updated 05/08/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JOSE JOSE
Position DIRECT OWNER
Phone (575) 652-4426
Fax
Practice Location
525 E LOHMAN AVE
STE D
LAS CRUCES NM, 88001-3394, US
Phone (575) 652-4426
Fax
Business Location
205 W BOUTZ RD
BLDG #1
LAS CRUCES NM, 88005-3262, US
Phone (575) 532-7000
Fax (575) 532-7111
Toxanomy
Taxonomy Code 207R00000X
License State New Mexico
License Number MD2011-0111
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According to our database, Internal Medicine Premium Health Care Pc NPI is 1124406269, taxonomy code is 207R00000X and license number is MD2011-0111, license state is located at New Mexico. Internal Medicine Premium Health Care Pc physically located at 525 E Lohman Ave, Las Cruces NM, 88001-3394. NPI Number 1033115704 has the healthcare provider type.

1124406269 NPI number is provided on an as is basis without warranty of any kind. 1124406269 is maintained by the National Plan & Provider Enumeration System. The contents of Internal Medicine Premium Health Care Pc are for informational purposes only.