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Organization
HUERTA MEDICAL LLC
Active
Organization
HUERTA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGIO A HUERTA DO (PRESIDENT)
(575) 649-9225
Entity
Organization
Contact information
Practice address
2801 E. MISSOURI AVE, STE 37, LAS CRUCES, NM 88011-9151
(575) 521-9485
Mailing address
PO BOX 13638, LAS CRUCES, NM 88013-3638
(575) 649-9225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42796
—
NM
01
—
DB2660
RR MEDICARE
—
01
—
NM011473
BCBS OF NM
NM
Enumeration date
08/23/2006
Last updated
10/17/2016
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