Juan Tabo Family Medicine PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD2007-0072 Issued in NM

Legal business name

JUAN TABO FAMILY MEDICINE PC

Practice address

3309 Juan Tabo Blvd NE
Suite C
Albuquerque, NM 87111-5131

Phone

(505) 554-1786

Fax

(505) 508-2482

NPI assigned

Jul 9, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ben Muneta, MD

Title

Registered Agent

Phone

(505) 554-1786

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1073825816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 JUAN TABO BLVD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115131",
            "telephone_number": "505-554-1786",
            "fax_number": "505-508-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 JUAN TABO BLVD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871115131",
            "telephone_number": "505-554-1786",
            "fax_number": "505-508-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN TABO FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "MUNETA",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "505-554-1786",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NM",
            "license": "MD2007-0072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CURRENT PROVIDER NUMBER",
            "identifier": "1477790327",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyfull Therapy LLC
• McKenzi R Jozic, D.P.T.
• JSKB Holdings
• Juan Casaus LLC
• Juan Tabo Dentistry LLC
• Juan Tabo Foot Health Center, PC
• Janice Alta Juan
• Maria Evelyn Juarez Parra
• Alejandra Isabel Juarez
• Alex Juarez

• Primary Care Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Primary Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.