Aztec Family Practice PA
Organization Active NPI Exclusive Provider Organization · Aztec, NM
NPI 1336348135 · NPPES record last updated May 20, 2008
Key facts
- NPI
- 1336348135
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- License
- A-834-86 (NM)
- Legal business name
- AZTEC FAMILY PRACTICE PA
- Practice address
- 406 S Park Ave
Aztec, NM 87410-2226 - Phone
- (505) 334-2852
- NPI assigned
- Jul 12, 2007
- Organization subpart
- No
Authorized official
- Name
- Bryan Poe
- Title
- Owner
- Phone
- (505) 334-2852
National Provider Directory
Locations
406 S Park Ave
Aztec, NM 87410
Phone (505) 334-2852
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | A-834-86 | NM | Yes |
Addresses
Primary practice location
406 S Park Ave
Aztec, NM 87410-2226
Mailing address
406 S Park Ave
Aztec, NM 87410-2226
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40931 | Medicaid | NM |
Other providers in Aztec, NM
- Beliarosa Avalos
- Aztec Care Holdings LLC
- Aztec Chiropractic Center
- Aztec Chiropractic Center, P.C.
- Aztec Family Dental Care, P.C.
- Aztec Healthcare LLC
- Aztec Municipal School District
- Aztec Municipal Schools
- Aztec Spa and Wellness
- Aztec Urgent Care, LLC
All providers in Aztec, NM · Exclusive Provider Organization in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.