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Organization
FAMILY MEDICINE PC
Active
Organization
FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE HENDERSON (CHIEF BUSINESS OFFICER)
(505) 494-5400
Entity
Organization
Contact information
Practice address
3825 EUBANK BLVD NE STE A, ALBUQUERQUE, NM 87111-3559
(505) 292-8575
(505) 292-8409
Mailing address
3825 EUBANK BLVD NE, ALBUQUERQUE, NM 87111-3575
(505) 292-8575
(505) 292-8409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44727
—
NM
Enumeration date
10/03/2007
Last updated
06/18/2024
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