Agnes Martinez Family Health Clinic

Organization Active NPI Health Service Clinic/Center · Mora, NM

NPI 1205010881 · NPPES record last updated Dec 19, 2007

Key facts

NPI
1205010881
Entity type
Organization (NPI type 2)
Primary specialty
Health Service Clinic/Center 261QH0100X
License
363LF0000X (NM)
Legal business name
AGNES MARTINEZ FAMILY HEALTH CLINIC
Practice address
State Highway 518 Mile Marker 29
Mora, NM 87732-0185
Phone
(505) 387-5503
Fax
(505) 387-5502
NPI assigned
Dec 19, 2007
Organization subpart
No

Authorized official

Name
Mrs. Mary Bunker, CNP
Title
Owner
Phone
(505) 387-5503

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 363LF0000X NM Yes

Addresses

Primary practice location

State Highway 518 Mile Marker 29
Mora, NM 87732-0185

Mailing address

PO Box 185
Mora, NM 87732-0185
Phone (505) 387-5503

Other providers in Mora, NM

All providers in Mora, NM · Health Service Clinic/Center in New Mexico

Sources for this page

Verify at the official NPI Registry.