Omar Lorenzo Izquierdo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD2003--0718 Issued in NM

Practice address

1960 N Date St
Truth Or Consequences, NM 87901-3701

Phone

(575) 894-7662

Fax

(575) 894-7930

NPI assigned

Sep 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Omar L. Izquierdo-Frau Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1891886529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 N DATE ST",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879013701",
            "telephone_number": "575-894-7662",
            "fax_number": "575-894-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "OMAR",
        "middle_name": "LORENZO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2003-0718",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2003--0718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OMAR",
            "last_name": "IZQUIERDO-FRAU",
            "middle_name": "L.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Family Medicine Physician in Truth Or Consequences, NM
• Providers in Truth Or Consequences, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.