Allen Michael Frey, R.T.
Individual provider Active NPI Radiography Radiologic Technologist · Dulce, NM
NPI 1629152764 · NPPES record last updated May 27, 2008
Key facts
- NPI
- 1629152764
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Radiography Radiologic Technologist 2471C3402X
- Practice address
- Jicarilla Apache Health Care Center
12000 Stone Lake Road
Dulce, NM 87528 - Phone
- (505) 759-3291
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiography Radiologic Technologist | 2471C3402X | Yes |
Addresses
Primary practice location
Jicarilla Apache Health Care Center
12000 Stone Lake Road
Dulce, NM 87528
Mailing address
HC 75 Box 189
Chama, NM 87520-9712
Phone (505) 756-7219
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000K3526 | Medicaid | NM | |
| HSZ196 | Other | NM | MEDICARE PART B |
Other providers in Dulce, NM
- Dulce Health Center
- Dulce Independent School District
- Dulce Independent Schools
- Carrie Lynn Emens
- Sonja H Emerson
- Ursula Michael Gabriel
- Reyna R Garcia
- Margaret Jean Gillean
- Michael W Goldberg
- Yolandra Gomez
All providers in Dulce, NM · Radiography Radiologic Technologist 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 27, 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.